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VICTOR CUETO JR. M.D.
NPI 1639439953
Internal Medicine in Miami, FL

Active since May 21, 2012PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
15155 SW 97TH AVE STE 100, MIAMI, FL 33176(305) 689-7272(305) 689-7273 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 18, 2025, Aug 5, 2024, Oct 20, 2021 and 1 more (4 updates tracked since 2019).

About Victor Cueto Jr. M.d. NPPES

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

VICTOR CUETO JR. M.D. (NPI 1639439953) is an individual internal medicine provider in Miami, Florida, licensed in Florida (ME140098) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and maintains a secondary practice location in Miami.

NPPES Registry Identity

NPI1639439953
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameVICTOR CUETO JR.Credential: M.D.
Location Address15155 SW 97TH AVE STE 100Miami, FL 33176-0049
Mailing Address15155 Sw 97th Ave Ste 100Miami, FL 33176-0049 · (305) 689-7272 · Fax (305) 689-7273
Phone(305) 689-7272
Fax(305) 689-7273
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateMay 21, 2012
Last NPPES UpdateNovember 18, 20254 updates tracked since enumeration
NPPES CertifiedNovember 18, 2025
✔ NPI 1639439953 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME140098
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.
Also ListedInternal Medicine · Obesity MedicineTaxonomy 207RB0002X · License ME140098 (FL)
Also ListedPediatricsTaxonomy 208000000X · License ME140098 (FL)
Also ListedPediatrics · Obesity MedicineTaxonomy 2080B0002X · License ME140098 (FL)
15155 SW 97TH AVE STE 100, Miami, FL 33176
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Other Names 1

Professional Name (2)Victor Cueto M.d.

Secondary Practice Location 1

Location 141214 Fisher Island DrMiami, FL 33109-1255 · Phone (305) 503-8634

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Victor Cueto Jr. 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 ID8527359934
PECOS Enrollment IDI20210824001955
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.

Medicare Billing Reassignment

Medicare enrollment records show Victor Cueto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Miami
3.9 mi
Internal Medicine
8932 SW 97TH AVE
Miami, FL 33176
  • Reassigned Medicare billing, Florida enrollment
  • 3,639 clinicians in this Medicare group
NPI 1912956566 (305) 243-7688

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

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.

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.
71 services43 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
37 services31 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.
35 services32 patients

Hospital Affiliations CMS Care Compare

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

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33176 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.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)
100%24 patients5/55-star benchmark: 100%
Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
3%37 patients
Breast Cancer Screening
47%129 patients3/55-star benchmark: 93%
Cervical Cancer Screening
47%199 patients2/55-star benchmark: 98%
Colorectal Cancer Screening
53%335 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
63%176 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
38%86 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
22%86 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
79%867 patients3/55-star benchmark: 100%
e-Prescribing
99%544 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
77%141 patients4/55-star benchmark: 100%
HIV Screening
51%468 patients4/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
52%535 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
50%484 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
26%527 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 98% · 296 patients
96%296 patients
Provide Patients Electronic Access to Their Health Information
96%221 patients4/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 11% · 151 patients
Patients totalRate: 21% · 151 patients
19%151 patients3/55-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.

DIANA LOURDES VILLAZON ARNP, FNP-BC
Nurse Practitioner (Family)
15155 SW 97TH AVE STE 100
MIAMI, FL 33176
Miami-Dade County (305) 528-5982
MADELINE ETKIN MLYNCZAK M.D., M.S.
Pediatrics
15155 SW 97TH AVE STE 100
MIAMI, FL 33176
Miami-Dade County (305) 689-7272

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 Victor Cueto's NPI number?

The NPI number for Victor Cueto is 1639439953. It was assigned to this individual provider in the NPPES registry on May 21, 2012. The provider is also known as Victor Cueto M.D..

Where is Victor Cueto located?

Victor Cueto practices at 15155 SW 97th Ave Ste 100, Miami, FL 33176. The listed phone number is (305) 689-7272.

What is Victor Cueto's specialty?

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

Is Victor Cueto enrolled in Medicare?

Yes. Victor Cueto 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.

Which organization bills Medicare for Victor Cueto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Victor Cueto reassigns Medicare benefits to University Of Miami (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Victor Cueto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Victor Cueto accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 3 other insurers list Victor Cueto 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 Victor Cueto affiliated with any hospitals?

According to CMS data, Victor Cueto is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Victor Cueto was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.