JOSE RAFAEL CANO PENALOZA M.D.
NPI 1770015950
Family Medicine in Mcallen, TX

Active since March 28, 2017PECOS EnrolledAccepts Medicare Assignment
81.44/100
CMS Quality Rating
205 E TORONTO AVE, MCALLEN, TX 78503(956) 687-6155(956) 682-0597 Get Directions Write a Review

NPPES record last updated: December 10, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 10, 2020, Sep 21, 2020, Mar 11, 2020 and 1 more (4 updates tracked since 2017).

About Jose Rafael Cano Penaloza M.d. NPPES

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

JOSE RAFAEL CANO PENALOZA M.D. (NPI 1770015950) is an individual family medicine provider in Mcallen, Texas, licensed in Texas (S5337) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Knapp Medical Center, and maintains a secondary practice location in Austin.

NPPES Registry Identity

NPI1770015950
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOSE RAFAEL CANO PENALOZACredential: M.D.
Location Address205 E TORONTO AVEMcallen, TX 78503-1209
Mailing Address205 E Toronto AveMcallen, TX 78503-1209 · (956) 687-6155 · Fax (956) 618-0451
Fax(956) 682-0597
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateMarch 28, 2017
Last NPPES UpdateDecember 10, 20204 updates tracked since enumeration
NPPES CertifiedDecember 10, 2020
NPI 1770015950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in TX · S5337
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.
205 E TORONTO AVE, Mcallen, TX 78503

Other Names 1

Professional Name (2)Jose Rafael Cano M.d.

Secondary Practice Location 1

Location 14316 James Casey St Ste B-100Austin, TX 78745-1142 · Phone (512) 444-4325 · Fax (512) 444-3327

Accepted 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

Jose Rafael Cano Penaloza 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 ID5991074296
PECOS Enrollment IDI20200327001138
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 3

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.
42 services38 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.
26 services23 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
13 services12 patients

Hospital Affiliations CMS Care Compare

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

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

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
$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.

81.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality65.83
Promoting Interoperability98
Improvement Activities40
Cost49.23

Reported Quality Measures

Breast Cancer Screening
37%174 patients2/55-star benchmark: 93%
Cervical Cancer Screening
52%250 patients3/55-star benchmark: 98%
Colorectal Cancer Screening
38%388 patients2/55-star benchmark: 88%
Controlling High Blood Pressure
55%354 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
18%230 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
58%230 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
87%1,343 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
97%208 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
69%697 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
66%556 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
42%592 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 97% · 649 patients
Patients screened: 99% · 649 patients
71%41 patients3/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
66%239 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
89%291 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 223 patients
Patients totalRate: 12% · 223 patients
12%223 patients3/55-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.

Psychologist (Clinical)
205 E TORONTO AVE
MCALLEN, TX 78503
Internal Medicine (Medical Oncology)
205 E TORONTO AVE
MCALLEN, TX 78503
Family Medicine
205 E TORONTO AVE
MCALLEN, TX 78503
Family Medicine
205 E TORONTO AVE
MCALLEN, TX 78503
Student in an Organized Health Care Education/Training Program
205 E TORONTO AVE
MCALLEN, TX 78503
Student in an Organized Health Care Education/Training Program
205 E TORONTO AVE
MCALLEN, TX 78503
Student in an Organized Health Care Education/Training Program
205 E TORONTO AVE
MCALLEN, TX 78503
Emergency Medicine
205 E TORONTO AVE
MCALLEN, TX 78503

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 Jose Cano Penaloza's NPI number?

The NPI number for Jose Cano Penaloza is 1770015950. It was assigned to this individual provider in the NPPES registry on March 28, 2017. The provider is also known as Jose Rafael Cano M.D..

Where is Jose Cano Penaloza located?

Jose Cano Penaloza practices at 205 E Toronto Ave, Mcallen, TX 78503. The listed phone number is (956) 687-6155.

What is Jose Cano Penaloza's specialty?

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

Is Jose Cano Penaloza enrolled in Medicare?

Yes. Jose Cano Penaloza 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 Jose Cano Penaloza 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 4 other insurers list Jose Cano Penaloza 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 Jose Cano Penaloza affiliated with any hospitals?

According to CMS data, Jose Cano Penaloza is affiliated with Knapp Medical Center.

When was this NPI record last updated?

The NPPES record for Jose Cano Penaloza was last updated on December 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.