SONYA MARIE SAENZ M.D
NPI 1245694868
Family Medicine in Mcallen, TX

Q: What is Sonya Saenz's NPI number?

The NPI number for Sonya Saenz is 1245694868. It was assigned to this individual provider in the NPPES registry on April 9, 2016.

Q: What is Sonya Saenz's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sonya Saenz was last updated on August 30, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 09, 2016PECOS EnrolledAccepts Medicare Assignment

81.44/100

CMS Quality Rating

1000 E DOVE AVE, MCALLEN, TX 78504(956) 362-3520 Get Directions Write a Review

NPPES record last updated: August 30, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Sonya Marie Saenz M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SONYA MARIE SAENZ M.D (NPI 1245694868) is an individual family medicine provider in Mcallen, Texas, licensed in Texas (S1909) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with Mission Regional Medical Center, and maintains a secondary practice location in Edinburg.

NPPES Registry Identity

NPI1245694868

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSONYA MARIE SAENZCredential: M.D

Location Address1000 E DOVE AVEMcallen, TX 78504-3974

Mailing Address2102 Treasure Hills Blvd # 3.14406Harlingen, TX 78550-8736 · (956) 296-1437 · Fax (956) 296-6842

Phone(956) 362-3520

Sole ProprietorYes

Medical School CMSUniversity Of Texas Medical Branch At GalvestonGraduated 2016

Enumeration DateApril 9, 2016

Last NPPES UpdateAugust 30, 2019

✔ NPI 1245694868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TX · S1909

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1000 E DOVE AVE, Mcallen, TX 78504

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Secondary Practice Location 1

Location 13804 S Jackson Rd Ste 2Edinburg, TX 78539-6682 · Phone (956) 296-3021 · Fax (956) 296-3020

Other Identifiers 2

Medicaid3996167-01TX

OtherH08LH87101TX · Bcbs-tx

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sonya Marie Saenz M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173812740

PECOS Enrollment IDI20190627002227

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

15 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mission Regional Medical Center

Acute Care Hospitals · Mission, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450176

Location900 South Bryan RoadMission, TX 78572 · Hidalgo County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78504 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

65.83

Promoting Interoperability

Improvement Activities

Cost

49.23

Reported Quality Measures

Breast Cancer Screening

24%213 patients2/55-star benchmark: 93%

Cervical Cancer Screening

28%435 patients2/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

54%48 patients3/55-star benchmark: 87%

Colorectal Cancer Screening

20%502 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

29%376 patients2/55-star benchmark: 91%

Diabetes: Eye Exam

7%273 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

82%273 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

38%1,516 patients1/55-star benchmark: 100%

e-Prescribing

95%240 patients3/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

47%184 patients2/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

27%962 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

26%758 patients2/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

13%1,157 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 45% · 863 patients

Patients screened: 46% · 863 patients

79%34 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

76%236 patients3/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

57%286 patients2/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 1% · 197 patients

Patients totalRate: 6% · 199 patients

6%199 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIA DE JESUS MUNOZ M.D.

Family Medicine