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OSCAR AMADOR OROPEZA M.D.
NPI 1437106374
Internal Medicine in Lake Wales, FL

Active since May 27, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
425 S 11TH ST, STE. 2, LAKE WALES, FL 33853(863) 676-8935(863) 679-2691 Get Directions Write a Review

NPPES record last updated: August 22, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Oscar Amador Oropeza M.d. NPPES

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

OSCAR AMADOR OROPEZA M.D. (NPI 1437106374) is an individual internal medicine provider in Lake Wales, Florida, licensed in Florida (ME87271) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Lake Wales, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1437106374
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameOSCAR AMADOR OROPEZACredential: M.D.
Location Address425 S 11TH ST, STE. 2Lake Wales, FL 33853-4239
Mailing Address425 S 11th St, Suite 2Lake Wales, FL 33853-4239 · (863) 676-8935 · Fax (863) 679-2691
Phone(863) 676-8935
Fax(863) 679-2691
Sole ProprietorYes
Medical School CMSOtherGraduated 1996
Enumeration DateMay 27, 2006
Last NPPES UpdateAugust 22, 2014
✔ NPI 1437106374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME87271
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
425 S 11TH ST, Lake Wales, FL 33853
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Other Identifiers 7

Other000808300FL · Medicaid Group Provider Number
Other71303FL · Blue Cross Blue Shield Fl
Medicaid266882300FL
Other5354999Cigna
OtherU0700YFL · Medicare Id
Other290817FL · Avmed
Medicare UPINH84441

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc. and more.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

Oscar Amador Oropeza 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 ID8022183698
PECOS Enrollment IDI20080930000533
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 3

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.
668 services223 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.
85 services60 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.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Adventhealth Lake Wales

Acute Care Hospitals · Lake Wales, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100099
Location410 S 11th StLake Wales, FL 33853 · Polk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33853 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%6,126 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
41%1,643 patients2/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
40%45 patients2/55-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 14

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

Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers12 claims70 services$16.31 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers17 claims17 services$47.76 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers15 claims15 services$16.03 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
7 suppliers22 claims119 services$1.71 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress E0295
DME-Hospital Beds · category DB000N
1 supplier15 claims15 services$44.25 avg. paid by Medicare
Bed side rails, half length E0305
DME-Hospital Beds · category DB000N
1 supplier16 claims16 services$7.08 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.

FLORIDA HOSPITAL PHYSICIAN GROUP INC
Urology
425 S 11TH ST
LAKE WALES, FL 33853
Polk County (863) 679-2707
DR. MAZVITA ETHEL SIMOYI MD
Surgery
425 S 11TH ST
LAKE WALES, FL 33853
Polk County (844) 634-3627
CAROLINE C HONCULADA M D LLC
Internal Medicine (Gastroenterology)
425 S 11TH ST, SUITE 1
LAKE WALES, FL 33853
Polk County (863) 679-9494
LAKE WALE PEDIATRIC INTERNAL MEDICINE P.A.
Clinic/Center (Primary Care)
425 S 11TH ST
LAKE WALES, FL 33853
Polk County (863) 676-8935

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 Oscar Oropeza's NPI number?

The NPI number for Oscar Oropeza is 1437106374. It was assigned to this individual provider in the NPPES registry on May 27, 2006.

Where is Oscar Oropeza located?

Oscar Oropeza practices at 425 S 11th St Ste. 2, Lake Wales, FL 33853. The listed phone number is (863) 676-8935.

What is Oscar Oropeza's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Oscar Oropeza enrolled in Medicare?

Yes. Oscar Oropeza 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 Oscar Oropeza accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Health First Commercial Plans, Inc., Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Oscar Oropeza 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 Oscar Oropeza affiliated with any hospitals?

According to CMS data, Oscar Oropeza is affiliated with Adventhealth Lake Wales.

When was this NPI record last updated?

The NPPES record for Oscar Oropeza was last updated on August 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.