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JOSE E ESPINEL MD
NPI 1497863211
Surgery in Carrollton, GA

Active since August 29, 2006PECOS EnrolledAccepts Medicare Assignment
157 CLINIC AVE STE 302, CARROLLTON, GA 30117(770) 834-3336(770) 832-2331 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 11, 2019, Jul 13, 2018, Jun 16, 2018 and 3 more (6 updates tracked since 2016).

About Jose E Espinel Md NPPES

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

JOSE E ESPINEL MD (NPI 1497863211) is an individual surgery provider in Carrollton, Georgia, licensed in Georgia (066288) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Tanner Medical Center - Carrollton, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1497863211
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJOSE E ESPINELCredential: MD
Location Address157 CLINIC AVE STE 302Carrollton, GA 30117
Mailing Address119 Ambulance Dr Ste 202Carrollton, GA 30117-3857 · (770) 838-8710
Phone(770) 834-3336
Fax(770) 832-2331
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateAugust 29, 2006
Last NPPES UpdateJune 11, 20196 updates tracked since enumeration
✔ NPI 1497863211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in GA · 066288
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
157 CLINIC AVE STE 302, Carrollton, GA 30117
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Other Identifiers 1

MedicaidPENDINGGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Jose E Espinel Md 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 ID547240517
PECOS Enrollment IDI20110809000162
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 7

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 straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
33 services20 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
26 services26 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.
24 services24 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.
23 services23 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.
19 services15 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.
14 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Tanner Medical Center - Carrollton

Acute Care Hospitals · Carrollton, GA
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110011
Location705 Dixie StreetCarrollton, GA 30117 · Carroll County
Birthing friendly

Tanner Medical Center Villa Rica

Acute Care Hospitals · Villa Rica, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110015
Location601 Dallas HighwayVilla Rica, GA 30180 · Carroll County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30117 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
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

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…
100%61 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 2

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

AUSTIN J LEWIS MD
Surgery
157 CLINIC AVE STE 302
CARROLLTON, GA 30117
Carroll County (770) 834-3336
DR. THOMAS ELLIS REEVE IV M.D.
Surgery (Vascular Surgery)
157 CLINIC AVE STE 302
CARROLLTON, GA 30117
Carroll County (770) 812-5902

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 Jose Espinel's NPI number?

The NPI number for Jose Espinel is 1497863211. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Where is Jose Espinel located?

Jose Espinel practices at 157 Clinic Ave Ste 302, Carrollton, GA 30117. The listed phone number is (770) 834-3336.

What is Jose Espinel's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Jose Espinel enrolled in Medicare?

Yes. Jose Espinel 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 Jose Espinel accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Jose Espinel 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 Jose Espinel affiliated with any hospitals?

According to CMS data, Jose Espinel is affiliated with Tanner Medical Center - Carrollton and Tanner Medical Center Villa Rica.

When was this NPI record last updated?

The NPPES record for Jose Espinel was last updated on June 11, 2019. 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.