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DR. BENEDICTO M ESTOESTA M.D.
NPI 1649451071
Family Medicine - Adult Medicine in Valley Springs, CA

Active since November 14, 2007PECOS EnrolledAccepts Medicare Assignment
55 S HIGHWAY 26 STE 1, VALLEY SPRINGS, CA 95252(209) 772-8906(209) 772-8950 Get Directions Write a Review

NPPES record last updated: November 14, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Benedicto M Estoesta M.d. NPPES

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

DR. BENEDICTO M ESTOESTA M.D. (NPI 1649451071) is an individual adult medicine provider in Valley Springs, California, licensed in California (A49318) and active in the NPI registry since November 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1983).

NPPES Registry Identity

NPI1649451071
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameDR. BENEDICTO M ESTOESTACredential: M.D.
Location Address55 S HIGHWAY 26 STE 1Valley Springs, CA 95252-8422
Mailing Address55 S Highway 26 Ste 1Valley Springs, CA 95252-8422 · (209) 772-8906 · Fax (209) 772-8950
Phone(209) 772-8906
Fax(209) 772-8950
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateNovember 14, 2007
✔ NPI 1649451071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in CA · A49318
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedAcupuncturistTaxonomy 171100000X · License A49318 (CA)
55 S HIGHWAY 26 STE 1, Valley Springs, CA 95252
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN00A493183CA

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. Benedicto M Estoesta 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 ID1456244995
PECOS Enrollment IDI20040206000621
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.

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.
1,457 services287 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.
980 services255 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
131 services131 patients
Face-to-face behavioral counseling for obesity, 15 minutes G0447
This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.
50 services32 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This 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.
48 services40 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95252 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
63%359 patients3/55-star benchmark: 96%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
57%130 patients2/55-star benchmark: 100%
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.
77%6,033 patients1/55-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.
Patients 1: 88% · 14,301 patients
88%14,301 patients4/55-star benchmark: 100%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
96%151 patients4/55-star benchmark: 100%
Medication Reconciliation
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.
100%137 patients5/55-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.
100%1,200 patients5/55-star benchmark: 100%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
Patients 1: 100% · 1,200 patients
100%1,200 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%1,200 patients1/55-star benchmark: 79%
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 26

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers43 claims106 services$6.48 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
2 suppliers12 claims12 services$2.95 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
2 suppliers12 claims28 services$1.24 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
7 suppliers23 claims23 services$44.20 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers12 claims24 services$1.69 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers18 claims18 services$93.06 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 2

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

BENEDICTO M. ESTOESTA M.D. INC
Family Medicine
55 S HIGHWAY 26 STE 1
VALLEY SPRINGS, CA 95252
Calaveras County (209) 772-8906
DR. MATTHEW G RICHARDSON D.C.
Chiropractor
55 S HIGHWAY 26 STE 1
VALLEY SPRINGS, CA 95252
Calaveras County (209) 772-8921

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 Benedicto Estoesta's NPI number?

The NPI number for Benedicto Estoesta is 1649451071. It was assigned to this individual provider in the NPPES registry on November 14, 2007.

Where is Benedicto Estoesta located?

Benedicto Estoesta practices at 55 S Highway 26 Ste 1, Valley Springs, CA 95252. The listed phone number is (209) 772-8906.

What is Benedicto Estoesta's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Benedicto Estoesta enrolled in Medicare?

Yes. Benedicto Estoesta 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.

When was this NPI record last updated?

The NPPES record for Benedicto Estoesta was last updated on November 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.