JOSEPH PAPROTA M.D.
NPI 1619183829
Internal Medicine - Pulmonary Disease in Miami Beach, FL

Q: What is the provider's specialty?

The provider's specialty is Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.

Active since May 15, 2007PECOS EnrolledAccepts Medicare Assignment

97.58/100

CMS Quality Rating

4302 ALTON RD STE 940, MIAMI BEACH, FL 33140(305) 674-2055(305) 674-2075 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 11, 2023, Sep 15, 2020, Jul 26, 2018 (3 updates tracked since 2018).

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About Joseph Paprota M.d. NPPES

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

JOSEPH PAPROTA M.D. (NPI 1619183829) is an individual pulmonary disease provider in Miami Beach, Florida, licensed in Florida (ME125300) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Mount Sinai Medical Center Of Florida, Inc, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1619183829

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameJOSEPH PAPROTACredential: M.D.

Location Address4302 ALTON RD STE 940Miami Beach, FL 33140-2890

Mailing Address4302 Alton Rd Ste 940Miami Beach, FL 33140-2890 · (305) 674-2055

Phone(305) 674-2055

Fax(305) 674-2075

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateMay 15, 2007

Last NPPES UpdateJanuary 11, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 11, 2023

✔ NPI 1619183829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

Licenses✔ Licensed in FL · ME125300✔ Licensed in PA · MD427201

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.

4302 ALTON RD STE 940, Miami Beach, FL 33140

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, AvMed 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

Joseph Paprota 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 ID9830240779

PECOS Enrollment IDI20151221002491

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 12

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.

215 services76 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.

176 services110 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.

150 services71 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.

77 services60 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.

59 services59 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.

45 services45 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

33 services32 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.

32 services30 patients

Test to measure expiratory airflow and volume 94010

This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.

30 services29 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.

28 services28 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

18 services17 patients

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

16 services16 patients

Hospital Affiliations CMS Care Compare 5

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

Mount Sinai Medical Center Of Florida, Inc

Acute Care Hospitals · Miami Beach, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100034

Location4300 Alton RdMiami Beach, FL 33140 · Miami-Dade County

Emergency services Birthing friendly

Memorial Regional Hospital

Acute Care Hospitals · Hollywood, FL

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100038

Location3501 Johnson StHollywood, FL 33021 · Broward County

Emergency services Birthing friendly

Lower Keys Medical Center

Acute Care Hospitals · Key West, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100150

Location5900 College RoadKey West, FL 33040 · Monroe County

Emergency services Birthing friendly

Fishermen's Community Hospital

Critical Access Hospitals · Marathon, FL

OwnershipVoluntary non-profit - Private

CMS Certification Number101312

Location3301 Overseas HwyMarathon, FL 33050 · Monroe County

Emergency services

Mariners Hospital

Critical Access Hospitals · Tavernier, FL

OwnershipVoluntary non-profit - Private

CMS Certification Number101313

Location91500 Overseas HighwayTavernier, FL 33070 · Monroe County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33140 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

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

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.

97.58/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Quality

86.53

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 13

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers14 claims14 services$21.41 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

3 suppliers28 claims28 services$7.52 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers12 claims12 services$46.07 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

5 suppliers300 claims300 services$114.72 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

4 suppliers286 claims286 services$37.33 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary G0333

DME-Other DME · category DE000N

8 suppliers24 claims24 services$43.02 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 7

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

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