DR. JORGE JUAN BACALLAO MD
NPI 1275549511
Ophthalmology in South Miami, FL

NPI Status: Active since July 31, 2006

Contact Information

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143
Phone: (305) 661-8588
Fax: (305) 661-4906

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  • Individual
  • Male
  • Years of Experience 49
  • Ophthalmology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JORGE BACALLAO

This page provides the complete NPI Profile along with additional information for Jorge Bacallao, a provider established in South Miami, Florida with a medical specialization in Ophthalmology and more than 49 years of experience. The healthcare provider is registered in the NPI registry with number 1275549511 assigned on July 2006. The practitioner's primary taxonomy code is 207W00000X with license number ME 92076 (FL). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1275549511
Provider Name
DR. JORGE JUAN BACALLAO MD
Gender
Male
Entity Type
Individual
Location Address
5858 SW 68TH ST SOUTH MIAMI, FL 33143
Location Phone
(305) 661-8588
Location Fax
(305) 661-4906
Mailing Address
5858 SW 68TH ST SOUTH MIAMI, FL 33143
Mailing Phone
(305) 661-8588
Mailing Fax
(305) 661-4906
Medical School Name
OTHER
Graduation Year
1977
Is Sole Proprietor?
Yes
Enumeration Date
07-31-2006
Last Update Date
02-15-2018
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Ophthalmologists like Jorge Bacallao specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Ophthalmology

Taxonomy Code
207W00000X
Type
Allopathic & Osteopathic Physicians
License No.
ME 92076
License State
FL
Taxonomy Description
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Clear VALUE Silver - HMO
  • Complete VALUE Gold - HMO
  • Focused VALUE Silver - HMO
  • Focused VALUE Silver + Vision + Adult Dental - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Standard Silver VALUE + Vision + Adult Dental - HMO
  • Complete VALUE Gold - HMO
  • Complete VALUE Silver - HMO
  • Elite VALUE Bronze - HMO
  • Focused VALUE Silver - HMO
  • Standard Expanded Bronze VALUE - HMO
  • Standard Gold VALUE - HMO
  • Standard Silver VALUE - HMO
  • Bronze 4 - HMO
  • Bronze 8 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with First 4 Primary Care Visits Free - HMO
  • Silver 8 - HMO
  • Silver 9 - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
268789500MEDICAID (05)FL 

Medicare Participation & PECOS Enrollment Status

Jorge Bacallao is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jorge Bacallao is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7810890480

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20040130000320

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

2d ultrasound scan of eye tissue and structures

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

This service was performed 38 times for 19 patients

Cataract surgery

Cataract surgery is a procedure to remove the lens of your eye when it becomes cloudy, which is called a cataract. A synthetic lens is then inserted to restore clear vision. The operation is typically done on an outpatient basis and is very safe and effective.

This service was performed for 1-10 patients

Established patient complete exam of visual system

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

This service was performed 37 times for 34 patients

Established patient problem focused exam of visual system

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

This service was performed 25 times for 18 patients

Exam of visual field with extended testing

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

This service was performed 25 times for 23 patients

Imaging of optic nerve

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

This service was performed 25 times for 25 patients

Imaging of retina

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

This service was performed 17 times for 17 patients

New patient complete exam of visual system

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

This service was performed 14 times for 14 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $35.39 for a new patient copayment and $18.96 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 33143 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $141.56
  • Minimum New Patient Price $60.92
  • Maximum New Patient Price $187.05
  • Average New Patient Copayment $35.39
  • Minimum New Patient Copayment $15.23
  • Maximum New Patient Copayment $46.76

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $75.86
  • Minimum Established Patient Price $18.99
  • Maximum Established Patient Price $150.24
  • Average Established Patient Copayment $18.96
  • Minimum Established Patient Copayment $4.74
  • Maximum Established Patient Copayment $37.56

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for DR. JORGE JUAN BACALLAO MD

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1275549511
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
221451041852
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 4 + 5 + 1 + 0 + 4 + 1 + 8 + 5 + 2 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 11

The NPI number 1275549511 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 7 providers are registered at the same or nearby location.

A JAMES SEGAL MD PA MEDEYEASSOCIATES

Ophthalmology

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(305) 661-8588

DR. ROBERT ORTIZ O.D.

Optometrist

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(305) 661-8588

MR. SANJAY NEDAL SMITH MD

Ophthalmology

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(305) 661-8588

JOANNA P WAHL D.O

Ophthalmology

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(305) 357-1711

ZACHARY KAUFMAN SEGAL M.D.

Ophthalmology

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(356) 661-8588

DR. HARISH RAJA MD

Ophthalmology

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(305) 661-8588

DR. PATRICK E BROWN OD

Optometrist

5858 SW 68TH ST
SOUTH MIAMI, FL
ZIP 33143

(305) 661-8588

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275549511, enumerated as an "individual" on July 31, 2006.

The provider is located at 5858 SW 68TH ST SOUTH MIAMI, FL 33143 and the phone number is (305) 661-8588.

Ophthalmology with taxonomy code 207W00000X.

The provider might be accepting Accepts: Ambetter from Superior HealthPlan, Ambetter. Please consult your insurance carrier or call the provider to verify.