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MARIO ISAAC BERROCAL O'HIGGINS M.D.
NPI 1649417627
Internal Medicine - Infectious Disease in Mcallen, TX

Active since January 13, 2009PECOS EnrolledAccepts Medicare Assignment
95.46/100
CMS Quality Rating
1200 E RIDGE RD, SUITE 8, MCALLEN, TX 78503(956) 630-5530(956) 630-5954 Get Directions Write a Review

NPPES record last updated: May 2, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mario Isaac Berrocal O'higgins M.d. NPPES

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

MARIO ISAAC BERROCAL O'HIGGINS M.D. (NPI 1649417627) is an individual infectious disease provider in Mcallen, Texas, licensed in Texas (N7525) and active in the NPI registry since January 2009. He is enrolled in Medicare PECOS, is affiliated with South Texas Health System, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1649417627
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameMARIO ISAAC BERROCAL O'HIGGINSCredential: M.D.
Location Address1200 E RIDGE RD, SUITE 8Mcallen, TX 78503-1527
Mailing Address1200 E Ridge Rd, Suite 8Mcallen, TX 78503-1527 · (956) 630-5530 · Fax (956) 630-5954
Phone(956) 630-5530
Fax(956) 630-5954
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJanuary 13, 2009
Last NPPES UpdateMay 2, 2011
✔ NPI 1649417627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in TX · N7525
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedInternal MedicineTaxonomy 207R00000X · License 125051146 (IL)
1200 E RIDGE RD, Mcallen, TX 78503
Open in Google Maps ↗

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

Mario Isaac Berrocal O'higgins 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 ID4789862640
PECOS Enrollment IDI20110623000119
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 5

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 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.
901 services208 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.
230 services143 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.
192 services180 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.
53 services30 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.
25 services25 patients

Hospital Affiliations CMS Care Compare 4

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

South Texas Health System

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450119
Location1102 W Trenton RoadEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Knapp Medical Center

Acute Care Hospitals · Weslaco, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450128
Location1401 East Eight StreetWeslaco, TX 78596 · Hidalgo County
Emergency services Birthing friendly

Rio Grande Regional Hospital

Acute Care Hospitals · Mcallen, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450711
Location101 E Ridge RdMcallen, TX 78503 · Hidalgo 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 78503 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.

95.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.92
Improvement Activities40
Cost87.65

Reported Quality Measures

Documentation of Current Medications in the Medical Record
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.
97%894 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%77 patients4/55-star benchmark: 100%
Patient-Specific Education
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.
39%178 patients2/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
7%242 patients1/55-star benchmark: 90%
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…
15%507 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
9%182 patients1/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
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
7%504 patients1/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 70% · 183 patients
73%183 patients
Provide Patient Access
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…
20%178 patients1/55-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 20

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

VERONICA RESENDEZ LLC
Family Medicine
1200 E RIDGE RD
MCALLEN, TX 78503
Hidalgo County (956) 631-3892
MARIA E HOFFMAN-GUARDIA M.D.
Pediatrics
1200 E RIDGE RD, STE.#12
MCALLEN, TX 78503
Hidalgo County (956) 631-5333
MR. KANNAN RAMAMURTHY M.D.
Internal Medicine
1200 E RIDGE RD, SUITE 7
MCALLEN, TX 78503
Hidalgo County (956) 631-3982
ELYSSA ELIZONDO
Physician Assistant
1200 E RIDGE RD
MCALLEN, TX 78503
Hidalgo County (956) 631-5333
SAENZ MEDICAL PHARMACY RIDGE, INC.
Pharmacy (Community/Retail Pharmacy)
1200 E RIDGE RD, SUITE 13
MCALLEN, TX 78503
Hidalgo County (956) 630-2500
MARLA MELINDA ANAYA PA-C
Physician Assistant
1200 E RIDGE RD, MED POINT CENTER II SUITE 12
MCALLEN, TX 78503
Hidalgo County (956) 631-5333
DR. MANGALA M RAMAMURTHY M.D.
Internal Medicine
1200 E RIDGE RD, SUITE 7
MCALLEN, TX 78503
Hidalgo County (956) 631-3982
WOMANKIND OB/GYN PA
Obstetrics & Gynecology
1200 E RIDGE RD, SUITE 3
MCALLEN, TX 78503
Hidalgo County (956) 688-5922

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 Mario Berrocal O'higgins's NPI number?

The NPI number for Mario Berrocal O'higgins is 1649417627. It was assigned to this individual provider in the NPPES registry on January 13, 2009.

Where is Mario Berrocal O'higgins located?

Mario Berrocal O'higgins practices at 1200 E Ridge Rd Suite 8, Mcallen, TX 78503. The listed phone number is (956) 630-5530.

What is Mario Berrocal O'higgins's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Mario Berrocal O'higgins enrolled in Medicare?

Yes. Mario Berrocal O'higgins 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 Mario Berrocal O'higgins 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 3 other insurers list Mario Berrocal O'higgins 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 Mario Berrocal O'higgins affiliated with any hospitals?

According to CMS data, Mario Berrocal O'higgins is affiliated with South Texas Health System, Knapp Medical Center, Rio Grande Regional Hospital and Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Mario Berrocal O'higgins was last updated on May 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.