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HECTOR CARBAJAL M.D.
NPI 1477704849
Internal Medicine in Houston, TX

Active since October 03, 2008PECOS EnrolledAccepts Medicare Assignment
98.93/100
CMS Quality Rating
6565 FANNIN ST, HOUSTON, TX 77030(281) 252-9993 Get Directions Write a Review

NPPES record last updated: February 5, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Hector Carbajal M.d. NPPES

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

HECTOR CARBAJAL M.D. (NPI 1477704849) is an individual internal medicine provider in Houston, Texas, licensed in Texas (P0355) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS, is affiliated with Houston Methodist Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1477704849
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameHECTOR CARBAJALCredential: M.D.
Location Address6565 FANNIN STHouston, TX 77030-2703
Mailing AddressPo Box 540064Houston, TX 77254-0064 · (713) 535-3972
Phone(281) 252-9993
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateOctober 3, 2008
Last NPPES UpdateFebruary 5, 2021
NPPES CertifiedFebruary 5, 2021
✔ NPI 1477704849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · P0355
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.
6565 FANNIN ST, Houston, TX 77030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Community Health Choice, Molina Healthcare.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

Hector Carbajal 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 ID7012189012
PECOS Enrollment IDI20111018000229
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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
1,434 services262 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
263 services230 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
169 services135 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
111 services55 patients

Hospital Affiliations CMS Care Compare

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

Houston Methodist Hospital

Acute Care Hospitals · Houston, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450358
Location6565 FanninHouston, TX 77030 · Harris County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
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.

98.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality97.15
Improvement Activities40
Cost83.57

Reported Quality Measures

Advance Care Plan
100%365 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%105 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
100%71 patients5/55-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.

Other Providers at the Same Location NPPES 20

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

SMAROULA DILIOGLOU PHD
Specialist/Technologist, Pathology
6565 FANNIN ST, MS205
HOUSTON, TX 77030
Harris County (713) 394-6450
MS. PRISCILLA DIAZ RN
Registered Nurse
6565 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 441-2030
HOUSTON METHODIST CARDIOVASCULAR ANESTHESIA
Anesthesiology
6565 FANNIN ST
HOUSTON, TX 77030
Harris County (832) 667-6097
LAN ZHOU MD
Pathology (Anatomic Pathology & Clinical Pathology)
6565 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 394-6450
DR. AMANDA WALTON BASFORD M.D.
Internal Medicine (Nephrology)
6565 FANNIN ST, FONDREN 270
HOUSTON, TX 77030
Harris County (713) 441-0006
MRS. AMY REYES MICLAT RN, MS, CCRN, APRN-B
Nurse Practitioner (Acute Care)
6565 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 441-4999
DR. MAHEEN ADAM WARDAK MD
Anesthesiology
6565 FANNIN ST
HOUSTON, TX 77030
Harris County (713) 441-2194
DR. SHUANG LI M.D.
Hospitalist
6565 FANNIN ST
HOUSTON, TX 77030
Harris County (832) 368-9466

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 Hector Carbajal's NPI number?

The NPI number for Hector Carbajal is 1477704849. It was assigned to this individual provider in the NPPES registry on October 3, 2008.

Where is Hector Carbajal located?

Hector Carbajal practices at 6565 Fannin St, Houston, TX 77030. The listed phone number is (281) 252-9993.

What is Hector Carbajal's specialty?

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

Is Hector Carbajal enrolled in Medicare?

Yes. Hector Carbajal 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 Hector Carbajal accept?

Health plans from Blue Cross and Blue Shield of Texas, Community Health Choice and Molina Healthcare list Hector Carbajal 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 Hector Carbajal affiliated with any hospitals?

According to CMS data, Hector Carbajal is affiliated with Houston Methodist Hospital.

When was this NPI record last updated?

The NPPES record for Hector Carbajal was last updated on February 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.