DR. FRANKLIN DANIEL PONCE HERRERA MD
NPI 1265849442
Internal Medicine - Nephrology in Mcallen, TX

Q: What is Franklin Ponce Herrera's NPI number?

The NPI number for Franklin Ponce Herrera is 1265849442. It was assigned to this individual provider in the NPPES registry on July 19, 2014.

Q: What is Franklin Ponce Herrera's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Active since July 19, 2014PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

409 LINDBERG AVE, MCALLEN, TX 78501(956) 682-1508(956) 682-0551 Get Directions Write a Review

NPPES record last updated: June 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 15, 2025, Sep 26, 2019, May 2, 2019 and 1 more (4 updates tracked since 2017).

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About Dr. Franklin Daniel Ponce Herrera Md NPPES

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

DR. FRANKLIN DANIEL PONCE HERRERA MD (NPI 1265849442) is an individual nephrology provider in Mcallen, Texas, licensed in Texas (S0776) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and maintains a secondary practice location in Paterson.

NPPES Registry Identity

NPI1265849442

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. FRANKLIN DANIEL PONCE HERRERACredential: MD

Location Address409 LINDBERG AVEMcallen, TX 78501-2921

Mailing Address409 Lindberg AveMcallen, TX 78501-2921 · (956) 682-1508 · Fax (956) 682-0551

Phone(956) 682-1508

Fax(956) 682-0551

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateJuly 19, 2014

Last NPPES UpdateJune 15, 20254 updates tracked since enumeration

NPPES CertifiedJune 15, 2025

✔ NPI 1265849442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in TX · S0776

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

409 LINDBERG AVE, Mcallen, TX 78501

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Secondary Practice Location 1

Location 1703 Main StPaterson, NJ 07503-2621 · Phone (973) 754-2000

Other Identifiers 4

Medicaid397214302TX

Other8LK837TX · Bcbs

Other804672TX · Medicare

OtherP02248975TX · Rr Medicare

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

Dr. Franklin Daniel Ponce Herrera Md 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 ID5193068518

PECOS Enrollment IDI20190528000810

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 11

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.

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

341 services80 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

312 services67 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

225 services93 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

163 services58 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

160 services98 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

119 services86 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

96 services50 patients

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.

95 services75 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

70 services54 patients

Dialysis services, 1 physician visit per month (20 years or older) 90962

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys canâ€™t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.

19 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

19 services19 patients

Hospital Affiliations CMS Care Compare 5

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450119

Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Knapp Medical Center

Acute Care Hospitals · Weslaco, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450128

Location1401 East Eight StreetWeslaco, TX 78596 · Hidalgo County

Emergency services Birthing friendly

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

Rio Grande Regional Hospital

Acute Care Hospitals · Mcallen, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450711

Location101 E Ridge RdMcallen, TX 78503 · Hidalgo County

Emergency services Birthing friendly

Doctors Hosptal At Renaissance

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipPhysician

CMS Certification Number450869

Location5501 South MccollEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78501 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

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.

75/100

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

Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers17 claims1,275 services$0.30 avg. paid by Medicare

Prednisone, immediate release or delayed release, oral, 1 mg J7512

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims825 services$0.01 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

3 suppliers12 claims12 services$18.90 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

3 suppliers17 claims19 services$11.95 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 7

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

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