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CARLOS ALBERTO HERRERA M.D.
NPI 1467435982
Obstetrics & Gynecology - Gynecologic Oncology in Edinburg, TX

Active since November 29, 2005PECOS EnrolledAccepts Medicare Assignment
86.22/100
CMS Quality Rating
2717 MICHAEL ANGELO, STE 304, EDINBURG, TX 78539(956) 362-2310(956) 362-2323 Get Directions Write a Review

NPPES record last updated: August 14, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 14, 2018, Jan 19, 2017, Nov 20, 2015 (3 updates tracked since 2015).

About Carlos Alberto Herrera M.d. NPPES

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

CARLOS ALBERTO HERRERA M.D. (NPI 1467435982) is an individual gynecologic oncology provider in Edinburg, Texas, licensed in Texas (J8573) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Doctors Hosptal At Renaissance, and is a graduate of University Of Texas Medical School At Houston (1994).

NPPES Registry Identity

NPI1467435982
Entity TypeIndividualMale
Primary Taxonomy207VX0201X
Provider Legal NameCARLOS ALBERTO HERRERACredential: M.D.
Location Address2717 MICHAEL ANGELO, STE 304Edinburg, TX 78539
Mailing AddressPo Box 2975Mcallen, TX 78502-2975 · (956) 362-2310 · Fax (956) 362-2323
Phone(956) 362-2310
Fax(956) 362-2323
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 1994
Enumeration DateNovember 29, 2005
Last NPPES UpdateAugust 14, 20183 updates tracked since enumeration
✔ NPI 1467435982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
License✔ Licensed in TX · J8573
Definition

An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

2717 MICHAEL ANGELO, Edinburg, TX 78539
Open in Google Maps ↗

Other Names 1

Professional Name (2)Carlos A Herrera M.d.

Other Identifiers 2

Medicaid131181310TX
Medicaid131181312TX

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carlos Alberto Herrera 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 ID5890757439
PECOS Enrollment IDI20041027000446
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 2

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.
108 services81 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.
28 services28 patients

Hospital Affiliations CMS Care Compare

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

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 78539 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
$166.88 typical visit price
range $54.84 – $166.88
Typical copayment $41.72 (range $13.71 – $41.72)
Most-billed visit code 99205
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.

86.22/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.03
Improvement Activities40

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.

GHANEM DAGHESTANI MD PA
Internal Medicine (Hematology & Oncology)
2717 MICHAEL ANGELO, SUITE 303
EDINBURG, TX 78539
Hidalgo County (956) 687-4600
OSCAR J GARCIA MD PA
Radiology (Radiation Oncology)
2717 MICHAEL ANGELO, RADIATION ONCOLOGY DEPT
EDINBURG, TX 78539
Hidalgo County (956) 217-7050
RGV HEMATO-ONCOLOGY, M.D., P.A.
Internal Medicine (Hematology & Oncology)
2717 MICHAEL ANGELO, SUITE 302
EDINBURG, TX 78539
Hidalgo County (956) 686-4221
GHANEM DAGHESTANI MD PA
Internal Medicine (Hematology & Oncology)
2717 MICHAEL ANGELO, SUITE 303
EDINBURG, TX 78539
Hidalgo County (956) 687-4600
SARADA GUMMADI MD PA
Internal Medicine
2717 MICHAEL ANGELO, SUITE 302
EDINBURG, TX 78539
Hidalgo County (956) 467-8382
GUMMADI & DESAI LLC
Clinical Medical Laboratory
2717 MICHAEL ANGELO, SUITE 302
EDINBURG, TX 78539
Hidalgo County (956) 668-1111

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 Carlos Herrera's NPI number?

The NPI number for Carlos Herrera is 1467435982. It was assigned to this individual provider in the NPPES registry on November 29, 2005.

Where is Carlos Herrera located?

Carlos Herrera practices at 2717 Michael Angelo Ste 304, Edinburg, TX 78539. The listed phone number is (956) 362-2310.

What is Carlos Herrera's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

Is Carlos Herrera enrolled in Medicare?

Yes. Carlos Herrera 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 Carlos Herrera 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 Carlos Herrera 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 Carlos Herrera affiliated with any hospitals?

According to CMS data, Carlos Herrera is affiliated with Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Carlos Herrera was last updated on August 14, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.