MICHELLE M. INSERRA MD
NPI 1356428205
Otolaryngology in San Jose, CA

Q: What is Michelle Inserra's NPI number?

The NPI number for Michelle Inserra is 1356428205. It was assigned to this individual provider in the NPPES registry on October 31, 2006.

Q: What is Michelle Inserra's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Michelle Inserra was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since October 31, 2006PECOS EnrolledAccepts Medicare Assignment

87.26/100

CMS Quality Rating

3071 PAYNE AVE, SAN JOSE, CA 95128(408) 540-5400(408) 540-5419 Get Directions Write a Review

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 11, 2025, Mar 4, 2021 (2 updates tracked since 2021).

On this page

About Michelle M. Inserra Md NPPES

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

MICHELLE M. INSERRA MD (NPI 1356428205) is an individual otolaryngology provider in San Jose, California, licensed in California (A73027) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Stanford University School Of Medicine (1999).

NPPES Registry Identity

NPI1356428205

Entity TypeIndividualFemale

Primary Taxonomy207Y00000X

Provider Legal NameMICHELLE M. INSERRACredential: MD

Location Address3071 PAYNE AVESan Jose, CA 95128-4054

Mailing Address3071 Payne AveSan Jose, CA 95128-4054 · (408) 540-5400 · Fax (408) 540-5419

Phone(408) 540-5400

Fax(408) 540-5419

Sole ProprietorNo

Medical School CMSStanford University School Of MedicineGraduated 1999

Enumeration DateOctober 31, 2006

Last NPPES UpdateFebruary 11, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 11, 2025

✔ NPI 1356428205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in CA · A73027

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

3071 PAYNE AVE, San Jose, CA 95128

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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

Michelle M. Inserra 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 ID3870571136

PECOS Enrollment IDI20040712001619

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 10

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.

215 services122 patients

Exam of ear using a microscope 92504

An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.

136 services84 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

105 services77 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.

84 services54 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

44 services44 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.

24 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95128 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

$156.67 typical visit price

range $70.37 – $206.04

Typical copayment $39.16 (range $17.59 – $51.51)

Most-billed visit code 99204

Established Patient

$86.56 typical visit price

range $23.96 – $169.60

Typical copayment $21.64 (range $5.99 – $42.40)

Most-billed visit code 99213

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.

87.26/100

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

Scored through an Alternative Payment Model

Quality

82.97

Promoting Interoperability

85.91

Improvement Activities

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

1%77 patients

Breast Cancer Screening

33%176 patients2/55-star benchmark: 93%

Cervical Cancer Screening

19%187 patients1/55-star benchmark: 98%

Colorectal Cancer Screening

17%384 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

54%59 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

76%1,244 patients3/55-star benchmark: 100%

e-Prescribing

100%146 patients5/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

8%353 patients1/55-star benchmark: 100%

HIV Screening

9%403 patients1/55-star benchmark: 60%

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

11%735 patients1/55-star benchmark: 98%

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

4%681 patients1/55-star benchmark: 97%

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

Patients screened: 62% · 239 patients

59%239 patients

Provide Patients Electronic Access to Their Health Information

95%257 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

70%115 patients3/55-star benchmark: 91%

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 7

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

EAR INNOVATIONS

Hearing Aid Equipment