DR. MARIA E JUSTINIANO M.D.
NPI 1619084217
Internal Medicine - Rheumatology in Mayaguez, PR
NPI Status: Active since August 23, 2006
Contact Information
CALLE DE DIEGO #115 ESTE
MAYAGUEZ, PR
ZIP 00680
Phone: (787) 806-3939
- Individual
- Female
- Years of Experience 28
- Internal Medicine
- Rheumatology
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MARIA JUSTINIANO
This page provides the complete NPI Profile along with additional information for Maria Justiniano, an internist established in Mayaguez, Puerto Rico with a medical specialization in Internal Medicine, focusing in rheumatology and more than 28 years of experience. She graduated from University Central Del Caribe Escuela De Medicina in 1998. The healthcare provider is registered in the NPI registry with number 1619084217 assigned on August 2006. The practitioner's primary taxonomy code is 207RR0500X with license number 16393 (PR). The provider is registered as an individual and her NPI record was last updated 15 years ago.
- NPI
- 1619084217
- Provider Name
- DR. MARIA E JUSTINIANO M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- CALLE DE DIEGO #115 ESTE MAYAGUEZ, PR 00680
- Location Phone
- (787) 806-3939
- Mailing Address
- CALLE DE DIEGO #115 ESTE MAYAGUEZ, PR 00680
- Mailing Phone
- (787) 806-3939
- Medical School Name
- UNIVERSITY CENTRAL DEL CARIBE ESCUELA DE MEDICINA
- Graduation Year
- 1998
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-23-2006
- Last Update Date
- 11-30-2011
- Code Navigator
An internist like Maria Justiniano is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Rheumatology
- Taxonomy Code
- 207RR0500X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 16393
- License State
- PR
- Taxonomy Description
- An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Medicare Participation & PECOS Enrollment Status
Maria Justiniano is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Maria Justiniano is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1153423454
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20070216000151
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 40-54 minutes
New patient office or other outpatient visit, 60-74 minutes
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 13 times for 11 patientsThis 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.
This service was performed 27 times for 20 patientsThis 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.
This service was performed 127 times for 53 patientsThis service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
This service was performed 26 times for 22 patientsThis is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
This service was performed 12 times for 12 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.66 for a new patient copayment and $25.06 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 00680 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.65
- Minimum New Patient Price $56.86
- Maximum New Patient Price $172.44
- Average New Patient Copayment $32.66
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.24
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.44
- Average Established Patient Copayment $25.06
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.11
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Care transition documentation practice improvements | Yes | N/A |
| Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.). | ||
| Depression screening | Yes | N/A |
| Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Diabetes: Foot Exam | 56% | 72 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| Documentation of Current Medications in the Medical Record | 100% | 971 |
| 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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 79% | 3927 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Falls: Screening for Future Fall Risk | 51% | 421 |
| Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Implementation of Use of Specialist Reports Back to Referring Clinician or Group to Close Referral Loop | Yes | N/A |
| Performance of regular practices that include providing specialist reports back to the referring individual MIPS eligible clinician or group to close the referral loop or where the referring individual MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the EHR technology. | ||
| Medication Reconciliation | 100% | 108 |
| The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician. | ||
| Participation in MOC Part IV | Yes | N/A |
| Participation in Maintenance of Certification (MOC) Part IV, such as the American Board of Internal Medicine (ABIM) Approved Quality Improvement (AQI) Program, National Cardiovascular Data Registry (NCDR) Clinical Quality Coach, Quality Practice Initiative Certification Program, American Board of Medical Specialties Practice Performance Improvement Module or ASA Simulation Education Network, for improving professional practice including participation in a local, regional or national outcomes registry or quality assessment program. Performance of monthly activities across practice to regularly assess performance in practice, by reviewing outcomes addressing identified areas for improvement and evaluating the results. | ||
| Participation in Quality Improvement Initiatives | Yes | N/A |
| Participation in other quality improvement programs such as Bridges to Excellence or American Board of Medical Specialties (ABMS) Multi-Specialty Portfolio Program. | ||
| Patient-Specific Education | 99% | 108 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Pneumococcal Vaccination Status for Older Adults | 60% | 421 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 43% | 580 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Provide Education Opportunities for New Clinicians | Yes | N/A |
| MIPS eligible clinicians acting as a preceptor for clinicians-in-training (such as medical residents/fellows, medical students, physician assistants, nurse practitioners, or clinical nurse specialists) and accepting such clinicians for clinical rotations in community practices in small, underserved, or rural areas. | ||
| Provide Patient Access | 81% | 108 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Tobacco use | Yes | N/A |
| Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
| Use evidence-based decision aids to support shared decision-making. | Yes | N/A |
| Use evidence-based decision aids to support shared decision-making. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
| Use of High-Risk Medications in the Elderly | 8% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better. | 421 |
| Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Maria Justiniano is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| HOSPITAL DE LA CONCEPCION | ROAD NUMBER 2 KM 173.4 CAIN ALTO SAN GERMAN, PR 00683 | (787) 892-1860 | Acute Care Hospitals |
Reviews for DR. MARIA E JUSTINIANO M.D.
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1619084217, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619084217, enumerated as an "individual" on August 23, 2006.
The provider is located at CALLE DE DIEGO #115 ESTE MAYAGUEZ, PR 00680 and the phone number is (787) 806-3939.
Internal Medicine with taxonomy code 207RR0500X and a focus in Rheumatology.
Maria Justiniano is affiliated with: HOSPITAL DE LA CONCEPCION.
