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CARLOS ALBERTO BARBA M.D.
NPI 1679581359
Surgery in Brownsville, TX

Active since August 04, 2006PECOS EnrolledAccepts Medicare Assignment
4970 N EXPRESSWAY, BROWNSVILLE, TX 78526(956) 621-4981(956) 621-4994 Get Directions Write a Review

NPPES record last updated: July 19, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 19, 2023, Mar 8, 2023 (2 updates tracked since 2023).

About Carlos Alberto Barba M.d. NPPES

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

CARLOS ALBERTO BARBA M.D. (NPI 1679581359) is an individual surgery provider in Brownsville, Texas, licensed in Texas (P7385) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Valley Baptist Medical Center- Brownsville, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1679581359
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameCARLOS ALBERTO BARBACredential: M.D.
Location Address4970 N EXPRESSWAYBrownsville, TX 78526-4268
Mailing Address4970 N ExpresswayBrownsville, TX 78526-4268 · (956) 621-4981 · Fax (956) 621-4994
Phone(956) 621-4981
Fax(956) 621-4994
Sole ProprietorYes
Medical School CMSOtherGraduated 1983
Enumeration DateAugust 4, 2006
Last NPPES UpdateJuly 19, 20232 updates tracked since enumeration
NPPES CertifiedJuly 19, 2023
✔ NPI 1679581359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in TX · P7385
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
4970 N EXPRESSWAY, Brownsville, TX 78526
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Other Identifiers 9

Medicaid001331066CT
Other202928529CT · United Healthcare
OtherP3887114CT · Oxford Health Plan
Other010033106CT03CT · Blue Cross Blue Shield
Other00133106602CT · Blue Care Family Plan
Other1200451-012CT · Cigna
Other2V6493CT · Healthnet
Other3962260CT · Aetna
Other622478CT · Connecticare

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

Carlos Alberto Barba 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 ID1052375417
PECOS Enrollment IDI20140118000254
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

2

Medicare enrollment records show Carlos Barba reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carlos A. Barba, MD, PLLC
Same address
Specialist
4970 N EXPRESSWAY STE A
Brownsville, TX 78526
  • Reassigned Medicare billing, Texas enrollment
  • 2 clinicians in this Medicare group
NPI 1235566019 (860) 836-2596
Premier General Surgeons PLLC
Same address
Surgery
4970 N EXPRESSWAY STE A
Brownsville, TX 78526
  • Reassigned Medicare billing, Texas enrollment
  • 3 clinicians in this Medicare group
NPI 1063112860 (956) 621-4981

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 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 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.
58 services40 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.
36 services36 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
20 services20 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.
16 services12 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Valley Baptist Medical Center- Brownsville

Acute Care Hospitals · Brownsville, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450028
Location1040 W Jefferson StBrownsville, TX 78520 · Cameron County
Emergency services Birthing friendly

Valley Regional Medical Center

Acute Care Hospitals · Brownsville, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450662
Location100 A Alton GloorBrownsville, TX 78526 · Cameron County
Emergency services Birthing friendly

Harlingen Medical Center

Acute Care Hospitals · Harlingen, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450855
Location5501 South Expressway 77Harlingen, TX 78550 · Cameron County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78526 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
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. RICARDO A ADAMES M.D.
Internal Medicine
4970 N EXPRESSWAY, SUITE D
BROWNSVILLE, TX 78526
Cameron County (956) 350-2050
RICARDO A. ADAMES, M.D.,P.A.
Internal Medicine (Infectious Disease)
4970 N EXPRESSWAY, SUITE D
BROWNSVILLE, TX 78526
Cameron County (956) 350-2050

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 Carlos Barba's NPI number?

The NPI number for Carlos Barba is 1679581359. It was assigned to this individual provider in the NPPES registry on August 4, 2006.

Where is Carlos Barba located?

Carlos Barba practices at 4970 N Expressway, Brownsville, TX 78526. The listed phone number is (956) 621-4981.

What is Carlos Barba's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Carlos Barba enrolled in Medicare?

Yes. Carlos Barba 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 Carlos Barba's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carlos Barba reassigns Medicare benefits to 2 organizations: Carlos A. Barba, MD, PLLC (Brownsville, TX) and Premier General Surgeons PLLC (Brownsville, 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 Carlos Barba's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carlos Barba 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 Carlos Barba 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 Carlos Barba affiliated with any hospitals?

According to CMS data, Carlos Barba is affiliated with Valley Baptist Medical Center- Brownsville, Valley Regional Medical Center and Harlingen Medical Center.

When was this NPI record last updated?

The NPPES record for Carlos Barba was last updated on July 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.