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DR. JUAN PABLO SARMIENTO M.D.
NPI 1568625432
Internal Medicine - Pulmonary Disease in Mcallen, TX

Active since July 09, 2008PECOS EnrolledAccepts Medicare Assignment
5300 N G ST STE 110, MCALLEN, TX 78504(956) 540-9766 Get Directions Write a Review

NPPES record last updated: May 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 11, 2023, Mar 22, 2023, Dec 21, 2022 and 3 more (6 updates tracked since 2021).

About Dr. Juan Pablo Sarmiento M.d. NPPES

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

DR. JUAN PABLO SARMIENTO M.D. (NPI 1568625432) is an individual pulmonary disease provider in Mcallen, Texas, licensed in Texas (Q3090) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Mission Regional Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1568625432
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. JUAN PABLO SARMIENTOCredential: M.D.
Location Address5300 N G ST STE 110Mcallen, TX 78504-6550
Mailing Address1112 E Griffin Pkwy Ste DMission, TX 78572-2408 · (956) 450-3093 · Fax (956) 631-9822
Phone(956) 540-9766
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJuly 9, 2008
Last NPPES UpdateMay 11, 20236 updates tracked since enumeration
NPPES CertifiedMay 11, 2023
✔ NPI 1568625432 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 · Q3090
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 MedicineTaxonomy 207R00000X · License TRN12410 (FL)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License Q3090 (TX)
5300 N G ST STE 110, Mcallen, TX 78504
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Secondary Practice Locations 2

Location 11112 E Griffin Pkwy Ste DMission, TX 78572-2408 · Phone (956) 450-3093 · Fax (956) 631-9822
Location 25501 S McColl RdEdinburg, TX 78539-5503 · Phone (956) 362-8677 · Fax (956) 362-7253

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

Dr. Juan Pablo Sarmiento 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 ID2668784471
PECOS Enrollment IDI20150708001542
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 11

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.

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.
246 services92 patients
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.
117 services51 patients
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.
92 services45 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.
32 services31 patients
Ultrasound scan of chest 76604
An ultrasound scan of the chest is a non-invasive imaging procedure that uses sound waves to create pictures of the structures within your chest, such as your heart and lungs. It's a safe, painless method that helps doctors diagnose and monitor various conditions.
28 services13 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.
22 services16 patients

Hospital Affiliations CMS Care Compare 3

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

Mission Regional Medical Center

Acute Care Hospitals · Mission, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450176
Location900 South Bryan RoadMission, TX 78572 · Hidalgo County
Birthing friendly

Starr County Memorial Hospital

Acute Care Hospitals · Rio Grande City, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450654
Location128 N Fm Rd 3167Rio Grande City, TX 78582 · Starr 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 78504 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.

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%101 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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers13 claims13 services$66.67 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers12 claims31 services$27.50 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers11 claims11 services$3.24 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier20 claims20 services$21.20 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers25 claims25 services$71.99 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 3

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

DR. JUAN MARCOS CHAVEZ PAZ M.D.
Internal Medicine (Pulmonary Disease)
5300 N G ST STE 110
MCALLEN, TX 78504
Hidalgo County (956) 540-9766
DR. JOSE FEDERICO VALLEJO-MANZUR M.D.
Internal Medicine (Pulmonary Disease)
5300 N G ST STE 110
MCALLEN, TX 78504
Hidalgo County (956) 540-9766
DR. ANTONIO DEGORORDO ARZAMENDI M.D.
Internal Medicine (Pulmonary Disease)
5300 N G ST STE 110
MCALLEN, TX 78504
Hidalgo County (956) 450-3093

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 Juan Pablo Sarmiento's NPI number?

The NPI number for Juan Pablo Sarmiento is 1568625432. It was assigned to this individual provider in the NPPES registry on July 9, 2008.

Where is Juan Pablo Sarmiento located?

Juan Pablo Sarmiento practices at 5300 N G St Ste 110, Mcallen, TX 78504. The listed phone number is (956) 540-9766.

What is Juan Pablo Sarmiento's specialty?

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

Is Juan Pablo Sarmiento enrolled in Medicare?

Yes. Juan Pablo Sarmiento 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 Juan Pablo Sarmiento 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 Juan Pablo Sarmiento 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 Juan Pablo Sarmiento affiliated with any hospitals?

According to CMS data, Juan Pablo Sarmiento is affiliated with Mission Regional Medical Center, Starr County Memorial Hospital and Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Juan Pablo Sarmiento was last updated on May 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.