DR. ADOLFO ENRIQUE KAPLAN M.D.
NPI 1417984899
Internal Medicine - Pulmonary Disease in Weslaco, TX

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment
90.85/100
CMS Quality Rating
1604 E 8TH ST, SUITE A, WESLACO, TX 78596(956) 447-5557(956) 447-5747 Get Directions Write a Review

NPPES record last updated: November 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Adolfo Enrique Kaplan M.d. NPPES

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

DR. ADOLFO ENRIQUE KAPLAN M.D. (NPI 1417984899) is an individual pulmonary disease provider in Weslaco, Texas, licensed in Texas (M0452) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1417984899
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. ADOLFO ENRIQUE KAPLANCredential: M.D.
Location Address1604 E 8TH ST, SUITE AWeslaco, TX 78596-5587
Mailing Address1604 E 8th St, Suite AWeslaco, TX 78596-5587 · (956) 447-5557 · Fax (956) 447-5747
Fax(956) 447-5747
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateJune 28, 2006
Last NPPES UpdateNovember 12, 2018
NPI 1417984899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in TX · M0452
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License M0452 (TX)
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License M0452 (TX)
1604 E 8TH ST, Weslaco, TX 78596

Other Identifiers 1

Medicaid171849601TX

Accepted Insurance

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

Dr. Adolfo Enrique Kaplan 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 ID6709832801
PECOS Enrollment IDI20050322000797
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 22

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.
596 services349 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.
299 services233 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
183 services63 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
141 services138 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
129 services128 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
128 services127 patients

Hospital Affiliations CMS Care Compare 3

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450119
Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Knapp Medical Center

Acute Care Hospitals · Weslaco, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450128
Location1401 East Eight StreetWeslaco, TX 78596 · Hidalgo County
Emergency services Birthing friendly

Doctors Hosptal At Renaissance

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipPhysician
CMS Certification Number450869
Location5501 South MccollEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78596 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

90.85/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality68.81
Promoting Interoperability94
Improvement Activities40
Cost75.35

Reported Quality Measures

Advance Care Plan
84%1,961 patients4/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
27%332 patients2/55-star benchmark: 87%
Colorectal Cancer Screening
3%2,132 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
55%475 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
2%232 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%232 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
99%6,608 patients4/55-star benchmark: 100%
e-Prescribing
95%1,810 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
8%1,704 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
45%3,427 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
16%4,635 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 95% · 2,638 patients
Patients screened: 98% · 2,638 patients
60%139 patients3/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
61%1,818 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
90%619 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 1,770 patients
Patients totalRate: 2% · 1,777 patients
2%1,777 patients4/55-star benchmark: 100%
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 37

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
2 suppliers22 claims88 services$18.90 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
2 suppliers22 claims660 services$36.56 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
12 suppliers180 claims180 services$32.10 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers19 claims38 services$1.19 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
16 suppliers213 claims213 services$73.38 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
16 suppliers216 claims584 services$27.72 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 6

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

Nurse Practitioner (Family)
1604 E 8TH ST, SUITE A
WESLACO, TX 78596
Internal Medicine (Pulmonary Disease)
1604 E 8TH ST, SUITE A
WESLACO, TX 78596
Internal Medicine (Pulmonary Disease)
1604 E 8TH ST, SUITE A
WESLACO, TX 78596
Obstetrics & Gynecology
1604 E 8TH ST, SUITE B
WESLACO, TX 78596
Internal Medicine (Pulmonary Disease)
1604 E 8TH ST, SUITE A
WESLACO, TX 78596
Internal Medicine (Pulmonary Disease)
1604 E 8TH ST, SUITE A
WESLACO, TX 78596

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 Adolfo Kaplan's NPI number?

The NPI number for Adolfo Kaplan is 1417984899. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Adolfo Kaplan located?

Adolfo Kaplan practices at 1604 E 8th St Suite A, Weslaco, TX 78596. The listed phone number is (956) 447-5557.

What is Adolfo Kaplan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Adolfo Kaplan enrolled in Medicare?

Yes. Adolfo Kaplan 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.

What insurance does Adolfo Kaplan 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 2 other insurers list Adolfo Kaplan 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 Adolfo Kaplan affiliated with any hospitals?

According to CMS data, Adolfo Kaplan is affiliated with South Texas Health System, Knapp Medical Center and Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Adolfo Kaplan was last updated on November 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.