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CAROLINA GOMEZ DE ZIEGLER MD
NPI 1669993143
Family Medicine in Edinburg, TX

Active since July 05, 2017PECOS EnrolledAccepts Medicare Assignment
90.37/100
CMS Quality Rating
2533 W TRENTON RD STE 8, EDINBURG, TX 78539(956) 609-7662(956) 474-9968 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 3, 2026, Aug 6, 2020, Jul 5, 2017 (3 updates tracked since 2017).

About Carolina Gomez De Ziegler Md NPPES

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

CAROLINA GOMEZ DE ZIEGLER MD (NPI 1669993143) is an individual family medicine provider in Edinburg, Texas, licensed in Texas (S3388) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS, is affiliated with Rio Grande Regional Hospital, and maintains a secondary practice location in Weslaco.

NPPES Registry Identity

NPI1669993143
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCAROLINA GOMEZ DE ZIEGLERCredential: MD
Location Address2533 W TRENTON RD STE 8Edinburg, TX 78539-5070
Mailing Address405 E ZenaidaMcallen, TX 78504-1683
Phone(956) 609-7662
Fax(956) 474-9968
Sole ProprietorYes
Medical School CMSOther
Enumeration DateJuly 5, 2017
Last NPPES UpdateMarch 3, 20263 updates tracked since enumeration
NPPES CertifiedMarch 3, 2026
✔ NPI 1669993143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · S3388
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedHospitalistTaxonomy 208M00000X · License S3388 (TX)
2533 W TRENTON RD STE 8, Edinburg, TX 78539
Open in Google Maps ↗

Secondary Practice Location 1

Location 11401 E Eight StWeslaco, TX 78596 · Phone (956) 296-1423

Other Identifiers 1

OtherH08MV75301TX · Bcbs

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carolina Gomez De Ziegler Md 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 ID3072935717
PECOS Enrollment IDI20200625000494
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 Reassignments

3

Medicare enrollment records show Carolina Gomez De Ziegler reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Soma Health PA
Same address
Family Medicine
2533 W TRENTON RD STE 8
Edinburg, TX 78539
  • Reassigned Medicare billing, Texas enrollment
  • 2 clinicians in this Medicare group
NPI 1386101491 (956) 663-1809
Soma Health, PLLC
Same address
Family Medicine
2533 W TRENTON RD STE 8
Edinburg, TX 78539
  • Reassigned Medicare billing, Texas enrollment
  • 2 clinicians in this Medicare group
NPI 1609737139 (956) 663-1809
Hni Medical Services
275 mi
Hospitalist
7500 RIALTO BLVD STE 1-140
Austin, TX 78735
  • Reassigned Medicare billing, Texas enrollment
  • 241 clinicians in this Medicare group
NPI 1366735169 (512) 730-3060

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 6

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.
54 services38 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.
47 services22 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.
35 services21 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
24 services23 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.
22 services22 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.
22 services21 patients

Hospital Affiliations CMS Care Compare 2

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

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 78539 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
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.

90.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality77.34
Promoting Interoperability100
Improvement Activities40
Cost57.23

Reported Quality Measures

Breast Cancer Screening
59%138 patients3/55-star benchmark: 93%
Cervical Cancer Screening
62%263 patients3/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
38%24 patients2/55-star benchmark: 87%
Colorectal Cancer Screening
46%317 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
56%227 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
19%184 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
58%184 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
71%1,440 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
48%196 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
52%681 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
61%534 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
25%619 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 72% · 593 patients
Patients screened: 74% · 593 patients
76%42 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
79%252 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
91%213 patients5/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 2% · 208 patients
Patients totalRate: 6% · 209 patients
4%209 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
1 supplier12 claims232 services$2.50 avg. paid by Medicare
Adhesive remover, wipes, any type, each A4456
DME-Medical/Surgical Supplies · category DA000N
1 supplier12 claims500 services$0.23 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
1 supplier12 claims500 services$0.23 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims341 services$4.72 avg. paid by Medicare
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims5,706 services$0.60 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.

SOMA HEALTH PA
Family Medicine
2533 W TRENTON RD STE 8
EDINBURG, TX 78539
Hidalgo County (956) 663-1809
SOMA HEALTH, PLLC
Family Medicine
2533 W TRENTON RD STE 8
EDINBURG, TX 78539
Hidalgo County (956) 663-1809

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 Carolina Gomez De Ziegler's NPI number?

The NPI number for Carolina Gomez De Ziegler is 1669993143. It was assigned to this individual provider in the NPPES registry on July 5, 2017.

Where is Carolina Gomez De Ziegler located?

Carolina Gomez De Ziegler practices at 2533 W Trenton Rd Ste 8, Edinburg, TX 78539. The listed phone number is (956) 609-7662.

What is Carolina Gomez De Ziegler's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Carolina Gomez De Ziegler enrolled in Medicare?

Yes. Carolina Gomez De Ziegler 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 organizations bill Medicare for Carolina Gomez De Ziegler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolina Gomez De Ziegler reassigns Medicare benefits to 3 organizations: Soma Health PA (Edinburg, TX), Soma Health, PLLC (Edinburg, TX) and Hni Medical Services (Austin, TX). Each 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 Carolina Gomez De Ziegler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carolina Gomez De Ziegler 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 1 other insurer list Carolina Gomez De Ziegler 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 Carolina Gomez De Ziegler affiliated with any hospitals?

According to CMS data, Carolina Gomez De Ziegler is affiliated with Rio Grande Regional Hospital and Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Carolina Gomez De Ziegler was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.