MARCO FRIAS MD
NPI 1356993281
Family Medicine in Binghamton, NY

Q: What is Marco Frias's NPI number?

The NPI number for Marco Frias is 1356993281. It was assigned to this individual provider in the NPPES registry on July 11, 2019.

Q: What is Marco Frias's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Marco Frias was last updated on September 23, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 11, 2019PECOS EnrolledAccepts Medicare Assignment

84.63/100

CMS Quality Rating

160 ROBINSON ST, BINGHAMTON, NY 13904(607) 296-2300 Get Directions Write a Review

NPPES record last updated: September 23, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 23, 2022, Jul 11, 2019 (2 updates tracked since 2019).

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About Marco Frias Md NPPES

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

MARCO FRIAS MD (NPI 1356993281) is an individual family medicine provider in Binghamton, New York, licensed in New York (319537) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1356993281

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMARCO FRIASCredential: MD

Location Address160 ROBINSON STBinghamton, NY 13904-1842

Mailing Address33 Lewis Rd, Fl 2Binghamton, NY 13905 · (607) 770-0025

Phone(607) 296-2300

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 11, 2019

Last NPPES UpdateSeptember 23, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2022

✔ NPI 1356993281 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 319537

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.

160 ROBINSON ST, Binghamton, NY 13904

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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

Marco Frias 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 ID6002240371

PECOS Enrollment IDI20230113000774

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.

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.

300 services139 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.

53 services43 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.

33 services33 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

20 services18 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Our Lady Of Lourdes Memorial Hospital, Inc

Acute Care Hospitals · Binghamton, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330011

Location169 Riverside DriveBinghamton, NY 13905 · Broome County

Emergency services Birthing friendly

United Health Services Hospitals, Inc

Acute Care Hospitals · Binghamton, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330394

Location10-42 Mitchell AvenueBinghamton, NY 13903 · Broome County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13904 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

84.63/100

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

Scored as part of a group practice

Quality

87.96

Promoting Interoperability

100

Improvement Activities

Cost

54.42

Other Providers at the Same Location NPPES 10

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

DR. VASILIOS TZOUMAS DO

Family Medicine