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DR. CARLOS EUGENIO COVARRUBIAS PONCE MD
NPI 1306839469
Family Medicine in Silver Spring, MD

Active since August 24, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 21D1098903 · Waiver
8121 GEORGIA AVE, SUITE 405, SILVER SPRING, MD 20910(301) 589-9480(301) 589-3872 Get Directions Write a Review

NPPES record last updated: March 26, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Carlos Eugenio Covarrubias Ponce Md NPPES

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

DR. CARLOS EUGENIO COVARRUBIAS PONCE MD (NPI 1306839469) is an individual family medicine provider in Silver Spring, Maryland, licensed in Maryland (D0048290) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through April 29, 2027, and is a graduate of Other (1978).

NPPES Registry Identity

NPI1306839469
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. CARLOS EUGENIO COVARRUBIAS PONCECredential: MD
Location Address8121 GEORGIA AVE, SUITE 405Silver Spring, MD 20910-4933
Mailing Address8121 Georgia Ave, Suite 405Silver Spring, MD 20910-4933 · (301) 589-9480 · Fax (301) 589-3872
Phone(301) 589-9480
Fax(301) 589-3872
Sole ProprietorNo
Medical School CMSOtherGraduated 1978
Enumeration DateAugust 24, 2005
Last NPPES UpdateMarch 26, 2008
✔ NPI 1306839469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MD · D0048290
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.
8121 GEORGIA AVE, Silver Spring, MD 20910
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Other Identifiers 3

Medicare UPING32939MD
OtherD0048290MD · Medical License
Medicaid921346500MD

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Carlos Eugenio Covarrubias Ponce 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 ID6800836297
PECOS Enrollment IDI20050504001236
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Carlos Covarrubias Ponce reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Privia Care Center LLC
9.0 mi
Internal Medicine
950 N GLEBE RD, SUITE 4000
Arlington, VA 22203
  • Reassigned Medicare billing, District of Columbia enrollment
  • 242 clinicians in this Medicare group
NPI 1164874426 (571) 366-8850
Privia Medical Group, LLC
9.0 mi
Internal Medicine
950 N GLEBE RD STE 700
Arlington, VA 22203
  • Reassigned Medicare billing, District of Columbia enrollment
  • 1,534 clinicians in this Medicare group
NPI 1013042480 (571) 366-8850

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D1098903

Carlos E Covarrubias MD & Associates · Silver Spring, MD
Active · expires Apr 29, 2027
CLIA Number21D1098903
Laboratory TypePhysician Office
Certificate Effective DateApril 30, 2025
Certificate Expiration DateApril 29, 2027
Laboratory DirectorCarlos E. Covarrubias
Laboratory Phone(301) 589-9480
Laboratory LocationCarlos E Covarrubias MD & Associates8121 Georgia Ave Ste 405, Silver Spring, MD 20910
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 9

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
315 services174 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.
215 services143 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.
162 services113 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
148 services148 patients
Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454
This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.
104 services15 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
69 services53 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20910 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
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.
98%6,670 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
61%1,666 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%364 patients5/55-star benchmark: 100%
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.
66%1,983 patients3/55-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%1,943 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…
43%1,943 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.
12%1,943 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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
16 suppliers74 claims182 services$5.88 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
1 supplier17 claims17 services$2.94 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers33 claims50 services$1.12 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers27 claims27 services$178.90 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

DR. LAWRENCE ALAN MANNING M.D.
Orthopaedic Surgery
8121 GEORGIA AVE, 701-A
SILVER SPRING, MD 20910
Montgomery County (301) 587-4180
AZEEM NAEEM
Behavior Technician
8121 GEORGIA AVE
SILVER SPRING, MD 20910
Montgomery County (301) 969-4214
LAWRENCE A. MANNING, MD
Specialist
8121 GEORGIA AVE, SUITE 701-A
SILVER SPRING, MD 20910
Montgomery County (301) 587-4180
SASHA MCCOY
Behavior Technician
8121 GEORGIA AVE
SILVER SPRING, MD 20910
Montgomery County (301) 969-4214
MRS. SILVIA ZALDUENDO
Physician Assistant
8121 GEORGIA AVE
SILVER SPRING, MD 20910
Montgomery County (301) 589-9480
SHORRELLE SHERI KENNEDY PSYCHOLOGIST
Psychologist
8121 GEORGIA AVE
SILVER SPRING, MD 20910
Montgomery County (301) 367-4827
DR. RAMESH SEAN JAGAN D.D.S.
Dentist
8121 GEORGIA AVE, SUITE 200
SILVER SPRING, MD 20910
Montgomery County (301) 585-7100
DR. ROBERT G GREENFIELD M.D.
General Practice
8121 GEORGIA AVE
SILVER SPRING, MD 20910
Montgomery County (301) 622-0112

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 Carlos Covarrubias Ponce's NPI number?

The NPI number for Carlos Covarrubias Ponce is 1306839469. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Carlos Covarrubias Ponce located?

Carlos Covarrubias Ponce practices at 8121 Georgia Ave Suite 405, Silver Spring, MD 20910. The listed phone number is (301) 589-9480.

What is Carlos Covarrubias Ponce's specialty?

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

Is Carlos Covarrubias Ponce enrolled in Medicare?

Yes. Carlos Covarrubias Ponce 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.

Which organizations bill Medicare for Carlos Covarrubias Ponce's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carlos Covarrubias Ponce reassigns Medicare benefits to 2 organizations: Privia Care Center LLC (Arlington, VA) and Privia Medical Group, LLC (Arlington, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carlos Covarrubias Ponce's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Does Carlos Covarrubias Ponce hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D1098903) is associated with this NPI, valid through April 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Carlos Covarrubias Ponce accept?

Health plans from Oscar Health list Carlos Covarrubias Ponce 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.

When was this NPI record last updated?

The NPPES record for Carlos Covarrubias Ponce was last updated on March 26, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.