CARMEN MARIE ESPINOSA
NPI 1790022101
Physician Assistant in San Antonio, TX

Active since January 07, 2013PECOS EnrolledAccepts Medicare Assignment
89.92/100
CMS Quality Rating
1055 ADA ST, SAN ANTONIO, TX 78223(210) 358-5515(210) 358-5530 Get Directions Write a Review

NPPES record last updated: February 8, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 8, 2021, Feb 1, 2021 (2 updates tracked since 2021).

About Carmen Marie Espinosa NPPES

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

CARMEN MARIE ESPINOSA (NPI 1790022101) is an individual physician assistant in San Antonio, Texas, licensed in Texas (PA08038) and active in the NPI registry since January 2013. She is enrolled in Medicare PECOS, is affiliated with University Health System, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1790022101
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCARMEN MARIE ESPINOSA
Location Address1055 ADA STSan Antonio, TX 78223-1703
Mailing AddressPo Box 734812Dallas, TX 75373-4812 · (210) 358-9500 · Fax (210) 358-9183
Fax(210) 358-5530
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJanuary 7, 2013
Last NPPES UpdateFebruary 8, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2021
NPI 1790022101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in TX · PA08038
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1055 ADA ST, San Antonio, TX 78223

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

Carmen Marie Espinosa 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 ID6204080203
PECOS Enrollment IDI20130128000527
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 2

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.
91 services74 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.
16 services15 patients

Hospital Affiliations CMS Care Compare

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

University Health System

Acute Care Hospitals · San Antonio, TX
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450213
Location4502 Medical DrSan Antonio, TX 78229 · Bexar County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78223 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.

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.

89.92/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.39
Promoting Interoperability100
Improvement Activities40
Cost62.89

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.

Obstetrics & Gynecology
1055 ADA ST
SAN ANTONIO, TX 78223
Internal Medicine (Geriatric Medicine)
1055 ADA ST, SOUTH BEXAR VA OUT PATIENT CLINIC
SAN ANTONIO, TX 78223
Clinic/Center (Federally Qualified Health Center (FQHC))
1055 ADA ST
SAN ANTONIO, TX 78223
Physician Assistant
1055 ADA ST
SAN ANTONIO, TX 78223
Physical Therapist
1055 ADA ST
SAN ANTONIO, TX 78223
Family Medicine
1055 ADA ST, CENTER FOR CHILDREN & FAMILIES, 4TH FLOOR
SAN ANTONIO, TX 78223
Counselor (Professional)
1055 ADA ST
SAN ANTONIO, TX 78223
Pharmacist (Ambulatory Care)
1055 ADA ST
SAN ANTONIO, TX 78223

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 Carmen Espinosa's NPI number?

The NPI number for Carmen Espinosa is 1790022101. It was assigned to this individual provider in the NPPES registry on January 7, 2013.

Where is Carmen Espinosa located?

Carmen Espinosa practices at 1055 Ada St, San Antonio, TX 78223. The listed phone number is (210) 358-5515.

What is Carmen Espinosa's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Carmen Espinosa enrolled in Medicare?

Yes. Carmen Espinosa 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 Carmen Espinosa accept?

Health plans from Blue Cross and Blue Shield of Texas, Imperial Insurance Companies, Inc. and Molina Healthcare list Carmen Espinosa 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 Carmen Espinosa affiliated with any hospitals?

According to CMS data, Carmen Espinosa is affiliated with University Health System.

When was this NPI record last updated?

The NPPES record for Carmen Espinosa was last updated on February 8, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.