JESUS ORNELAS M.D
NPI 1376877787
Pediatrics - Adolescent Medicine in Palmetto Bay, FL
NPI Status: Active since October 01, 2009
Contact Information
8620 SW 146TH ST
PALMETTO BAY, FL
ZIP 33158
Phone: (305) 395-9589
- Individual
- Male
- Years of Experience 18
- Pediatrics
- Adolescent Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About JESUS ORNELAS
This page provides the complete NPI Profile along with additional information for Jesus Ornelas, a pediatrician established in Palmetto Bay, Florida with a medical specialization in Pediatrics, focusing in adolescent medicine and more than 18 years of experience. The healthcare provider is registered in the NPI registry with number 1376877787 assigned on October 2009. The practitioner's primary taxonomy code is 2080A0000X with license number ME118252 (FL). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1376877787
- Provider Name
- JESUS ORNELAS M.D
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 8620 SW 146TH ST PALMETTO BAY, FL 33158
- Location Phone
- (305) 395-9589
- Mailing Address
- 8620 SW 146TH ST PALMETTO BAY, FL 33158
- Mailing Phone
- (305) 395-9589
- Medical School Name
- OTHER
- Graduation Year
- 2008
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-01-2009
- Last Update Date
- 11-30-2020
- Code Navigator
A pediatrician like Jesus Ornelas is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
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
Pediatrics Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME118252
- License State
- FL
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2080A0000X | Allopathic & Osteopathic Physicians | Pediatrics | 25MA09102700 (NJ) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-06 (Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
- BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
- Molina Bronze Enhanced 3500 - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
- Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
- Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
- Molina Bronze Standard - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Core 1640 Plus with Adult Vision - HMO
- Molina Gold Enhanced 895 - HMO
- Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
- Molina Gold Enhanced 895 Plus with Adult Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Access - HMO
- Molina Silver Access Plus with Adult Dental and Vision - HMO
- Molina Silver Access Plus with Adult Vision - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with AdventHealth - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with AdventHealth - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with AdventHealth - HMO
- Gold Elite Saver Plus | with AdventHealth - HMO
- Gold Simple - HMO
- Gold Simple | with AdventHealth - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with AdventHealth - HMO
- Silver Elite - HMO
- Silver Elite | with AdventHealth - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Silver Simple Chronic Care CKM - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic 4700 | MercyOne - EPO
- Bronze Classic Standard - EPO
- Bronze Classic Standard | MercyOne - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Elite + PCP Saver Plus | MercyOne - EPO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
- Bronze Simple Chronic Care CKM | MercyOne - EPO
- Bronze Simple Diabetes | MercyOne - EPO
- Gold Classic Standard - EPO
- Gold Classic Standard | MercyOne - EPO
- Gold Elite - EPO
- Gold Elite | MercyOne - EPO
- Secure - EPO
- Secure | MercyOne - EPO
- Silver Classic - EPO
- Silver Classic | MercyOne - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard | MercyOne - EPO
- Silver Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jesus Ornelas 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.
Jesus Ornelas 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: 1951566280
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: I20140922000797
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
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1376877787, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376877787, enumerated as an "individual" on October 01, 2009.
The provider is located at 8620 SW 146TH ST PALMETTO BAY, FL 33158 and the phone number is (305) 395-9589.
Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.
The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Molina. Please consult your insurance carrier or call the provider to verify.
