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MR. ARTHUR GINO ENCARNACION NP
NPI 1295947554
Nurse Practitioner in Houston, TX

Active since May 07, 2007PECOS EnrolledAccepts Medicare Assignment
11800 ASTORIA BLVD STE E2031.1, HOUSTON, TX 77089(281) 929-6291 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 16, 2024, Jul 17, 2024 (2 updates tracked since 2024).

About Mr. Arthur Gino Encarnacion Np NPPES

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

MR. ARTHUR GINO ENCARNACION NP (NPI 1295947554) is an individual nurse practitioner in Houston, Texas, licensed in Texas (AP113875) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Memorial Hermann Hospital System, and maintains a secondary practice location in Houston.

NPPES Registry Identity

NPI1295947554
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. ARTHUR GINO ENCARNACIONCredential: NP
Location Address11800 ASTORIA BLVD STE E2031.1Houston, TX 77089-6041
Mailing AddressPo Box 704Friendswood, TX 77549-0704 · (713) 898-4412
Phone(281) 929-6291
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMay 7, 2007
Last NPPES UpdateSeptember 16, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2024
✔ NPI 1295947554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in TX · AP113875✔ Licensed in TX · 588848
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License AP113875 (TX)
11800 ASTORIA BLVD STE E2031.1, Houston, TX 77089
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Secondary Practice Location 1

Location 17887 Cambridge StHouston, TX 77054-2013 · Phone (713) 898-4412

Other Identifiers 3

Other1295947554TX · Blue Cross Blue Shield
Medicaid282202502TX
Other588848TX · Nursing Liscense

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Community Health Choice, Oscar Insurance Company.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

Mr. Arthur Gino Encarnacion Np 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 ID3678750627
PECOS Enrollment IDI20110531000687
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 5

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.

Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
173 services86 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.
62 services60 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.
60 services41 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.
54 services34 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.
20 services19 patients

Hospital Affiliations CMS Care Compare

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

Memorial Hermann Hospital System

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450184
Location1635 North Loop WestHouston, TX 77008 · Harris County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77089 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
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%480 patients4/55-star benchmark: 99%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
79%132 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%132 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
42%132 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
17%132 patients
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.

Other Providers at the Same Location NPPES

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

CHRISTINE HAN FENG DO
Family Medicine (Hospice and Palliative Medicine)
11800 ASTORIA BLVD STE E2031.1
HOUSTON, TX 77089
Harris County (281) 929-6291

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Arthur Encarnacion's NPI number?

The NPI number for Arthur Encarnacion is 1295947554. It was assigned to this individual provider in the NPPES registry on May 7, 2007.

Where is Arthur Encarnacion located?

Arthur Encarnacion practices at 11800 Astoria Blvd Ste E2031.1, Houston, TX 77089. The listed phone number is (281) 929-6291.

What is Arthur Encarnacion's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Arthur Encarnacion enrolled in Medicare?

Yes. Arthur Encarnacion is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Arthur Encarnacion accept?

Health plans from Blue Cross and Blue Shield of Texas, Community Health Choice and Oscar Insurance Company list Arthur Encarnacion as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Arthur Encarnacion affiliated with any hospitals?

According to CMS data, Arthur Encarnacion is affiliated with Memorial Hermann Hospital System.

When was this NPI record last updated?

The NPPES record for Arthur Encarnacion was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.