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DR. MIGUEL A. PIRELA-CRUZ M.D.
NPI 1386604767
Orthopaedic Surgery - Hand Surgery in El Paso, TX

Active since March 28, 2006PECOS EnrolledAccepts Medicare Assignment
1540 N ZARAGOZA RD, EL PASO, TX 79936(915) 592-3323 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Miguel A. Pirela-cruz M.d. NPPES

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

DR. MIGUEL A. PIRELA-CRUZ M.D. (NPI 1386604767) is an individual hand surgery provider in El Paso, Texas, licensed in Texas (K4649) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with University Medical Center Of El Paso, and is a graduate of Temple University School Of Medicine (1980).

NPPES Registry Identity

NPI1386604767
Entity TypeIndividualMale
Primary Taxonomy207XS0106X
Provider Legal NameDR. MIGUEL A. PIRELA-CRUZCredential: M.D.
Location Address1540 N ZARAGOZA RDEl Paso, TX 79936-7905
Mailing Address1540 N Zaragoza RdEl Paso, TX 79936-7905 · (915) 592-3323
Phone(915) 592-3323
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 1980
Enumeration DateMarch 28, 2006
Last NPPES UpdateMarch 22, 2024
NPPES CertifiedMarch 22, 2024
✔ NPI 1386604767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
License✔ Licensed in TX · K4649
Definition
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License L4649 (TX)
1540 N ZARAGOZA RD, El Paso, TX 79936
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Other Identifiers 1

Medicaid141675202TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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. Miguel A. Pirela-cruz M.d. 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 ID9133289200
PECOS Enrollment IDI20081119000275
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

3

Medicare enrollment records show Miguel Pirela-cruz reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

El Paso County Hospital District
0.9 mi
General Acute Care Hospital
1416 GEORGE DIETER DR
El Paso, TX 79936
  • Reassigned Medicare billing, Texas enrollment
  • 409 clinicians in this Medicare group
NPI 1619747938 (915) 521-2259
Umc El Paso Healthcare Inc
3.6 mi
General Practice
10410 VISTA DEL SOL DR
El Paso, TX 79925
  • Reassigned Medicare billing, Texas enrollment
  • 77 clinicians in this Medicare group
NPI 1528683810 (915) 200-2680
Texas Tech University Health Sciences Center
6.1 mi
Family Medicine
313 S RIO VISTA RD
El Paso, TX 79927
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Texas Tech University Health Sciences Center El Paso
  • 856 clinicians in this Medicare group
NPI 1588622500 (915) 859-0817

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

Areas of Expertise CMS Part B claims 4

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.
39 services31 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.
38 services38 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.
18 services18 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.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

University Medical Center Of El Paso

Acute Care Hospitals · El Paso, TX
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450024
Location4815 Alameda AveEl Paso, TX 79905 · El Paso County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79936 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
5%305 patients1/55-star benchmark: 96%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
1%560 patients1/55-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…
15%206 patients1/55-star benchmark: 98%
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.
96%247 patients4/55-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.
36%440 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
99%1,068 patients4/55-star benchmark: 100%
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…
95%440 patients4/55-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…
19%440 patients1/55-star benchmark: 79%
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

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908
DME-Orthotic Devices · category DF000N
3 suppliers27 claims29 services$58.02 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 4

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

SM OT RESOURCES LLC
Occupational Therapist
1540 N ZARAGOZA RD, SUITE A-12
EL PASO, TX 79936
El Paso County (915) 921-6881
DR. CARLOS GONZALEZ M.D.
Orthopaedic Surgery
1540 N ZARAGOZA RD
EL PASO, TX 79936
El Paso County (915) 592-3323
DR. EMILY MARTINEZ PT, DPT
Physical Therapist
1540 N ZARAGOZA RD
EL PASO, TX 79936
El Paso County (915) 592-3323
GUADALUPE IVONNE ARMENTA CARRASCO APRN-CNP
Nurse Practitioner (Family)
1540 N ZARAGOZA RD
EL PASO, TX 79936
El Paso County (915) 592-3323

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 Miguel Pirela-cruz's NPI number?

The NPI number for Miguel Pirela-cruz is 1386604767. It was assigned to this individual provider in the NPPES registry on March 28, 2006.

Where is Miguel Pirela-cruz located?

Miguel Pirela-cruz practices at 1540 N Zaragoza Rd, El Paso, TX 79936. The listed phone number is (915) 592-3323.

What is Miguel Pirela-cruz's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is Miguel Pirela-cruz enrolled in Medicare?

Yes. Miguel Pirela-cruz 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 Miguel Pirela-cruz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Miguel Pirela-cruz reassigns Medicare benefits to 3 organizations: El Paso County Hospital District (El Paso, TX), Umc El Paso Healthcare Inc (El Paso, TX) and Texas Tech University Health Sciences Center (El Paso, TX). 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 Miguel Pirela-cruz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Miguel Pirela-cruz accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Miguel Pirela-cruz 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 Miguel Pirela-cruz affiliated with any hospitals?

According to CMS data, Miguel Pirela-cruz is affiliated with University Medical Center Of El Paso.

When was this NPI record last updated?

The NPPES record for Miguel Pirela-cruz was last updated on March 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.