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SHEILA PAOLA RAMIREZ-RODRIGUEZ MD
NPI 1740415405
Internal Medicine - Endocrinology, Diabetes & Metabolism in Martinsburg, WV

Active since May 26, 2009PECOS EnrolledAccepts Medicare Assignment
93.1/100
CMS Quality Rating
120 CAMPUS DR STE 221, MARTINSBURG, WV 25404(681) 247-1280(681) 247-1281 Get Directions Write a Review

NPPES record last updated: February 18, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sheila Paola Ramirez-rodriguez Md NPPES

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

SHEILA PAOLA RAMIREZ-RODRIGUEZ MD (NPI 1740415405) is an individual endocrinology, diabetes & metabolism provider in Martinsburg, West Virginia, licensed in West Virginia (24385) and active in the NPI registry since May 2009. She is enrolled in Medicare PECOS, is affiliated with Winchester Medical Center, and maintains a secondary practice location in Martinsburg.

NPPES Registry Identity

NPI1740415405
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameSHEILA PAOLA RAMIREZ-RODRIGUEZCredential: MD
Location Address120 CAMPUS DR STE 221Martinsburg, WV 25404-7561
Mailing Address220 Campus Blvd Ste 320Winchester, VA 22601-2889 · (540) 536-5100 · Fax (540) 536-0235
Phone(681) 247-1280
Fax(681) 247-1281
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMay 26, 2009
Last NPPES UpdateFebruary 18, 2026
NPPES CertifiedFebruary 18, 2026
✔ NPI 1740415405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in WV · 24385
Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

120 CAMPUS DR STE 221, Martinsburg, WV 25404
Open in Google Maps ↗

Secondary Practice Location 1

Location 1307 Medical CtMartinsburg, WV 25401-2843 · Phone (304) 260-1436 · Fax (304) 260-1437

Other Identifiers 1

Medicaid3810021207WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.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

Sheila Paola Ramirez-rodriguez 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 ID1355514811
PECOS Enrollment IDI20111027000570
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 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.
789 services296 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
445 services180 patients
Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
325 services131 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.
32 services29 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 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.
14 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Winchester Medical Center

Acute Care Hospitals · Winchester, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490005
Location1840 Amherst StWinchester, VA 22601 · Winchester City County
Emergency services Birthing friendly

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Valley Health War Memorial Hospital

Critical Access Hospitals · Berkeley Springs, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511309
Location1 Healthy WayBerkeley Springs, WV 25411 · Morgan County
Emergency services

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511319
Location300 South Preston StreetRanson, WV 25438 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25404 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
$124.46 typical visit price
range $53.20 – $164.59
Typical copayment $31.11 (range $13.30 – $41.14)
Most-billed visit code 99204
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
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.

93.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.7
Promoting Interoperability100
Improvement Activities40
Cost78.55

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
45%442 patients2/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
29%404 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
46%668 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
1%714 patients1/55-star benchmark: 100%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
8%713 patients1/55-star benchmark: 98%
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
89%714 patients4/55-star benchmark: 99%
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%3,038 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.
97%1,212 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
40%356 patients2/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
55%800 patients3/55-star benchmark: 96%
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%800 patients5/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
49%358 patients3/55-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…
43%1,160 patients2/55-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
24%1,090 patients2/55-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
21%890 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 screenedForUse: 100% · 918 patients
Patients tobacco: 93% · 918 patients
51%138 patients3/55-star benchmark: 98%
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…
100%800 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…
63%800 patients5/55-star benchmark: 59%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 358 patients
1%358 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 8

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
6 suppliers51 claims643 services$17.51 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
6 suppliers50 claims1,689 services$2.28 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
31 suppliers133 claims512 services$6.16 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers33 claims69 services$1.09 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers33 claims33 services$314.93 avg. paid by Medicare
Insulin for administration through dme (i.e., insulin pump) per 50 units J1817
Treatment-Injections and Infusions (nononcologic) · category RI000N
4 suppliers27 claims2,880 services$6.28 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.

DR. JAMES CARRIER M.D.
Specialist
120 CAMPUS DR STE 221
MARTINSBURG, WV 25404
Berkeley County (681) 247-1280
ZACHARY AARON-FRANCIS KISTKA MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
120 CAMPUS DR STE 221
MARTINSBURG, WV 25404
Berkeley County (681) 247-1280

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 Sheila Ramirez-rodriguez's NPI number?

The NPI number for Sheila Ramirez-rodriguez is 1740415405. It was assigned to this individual provider in the NPPES registry on May 26, 2009.

Where is Sheila Ramirez-rodriguez located?

Sheila Ramirez-rodriguez practices at 120 Campus Dr Ste 221, Martinsburg, WV 25404. The listed phone number is (681) 247-1280.

What is Sheila Ramirez-rodriguez's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Sheila Ramirez-rodriguez enrolled in Medicare?

Yes. Sheila Ramirez-rodriguez 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 Sheila Ramirez-rodriguez accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list Sheila Ramirez-rodriguez 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 Sheila Ramirez-rodriguez affiliated with any hospitals?

According to CMS data, Sheila Ramirez-rodriguez is affiliated with Winchester Medical Center, Berkeley Medical Center, Valley Health War Memorial Hospital and Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for Sheila Ramirez-rodriguez was last updated on February 18, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.