JOEL SARMIENTO
Accepted Insurance for NPI 1790148708
Pediatrics in Austin, TX

Q: What managed care network types are accepted by this provider?

JOEL SARMIENTO is enrolled across the following managed care network types: EPO, HMO, PPO. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.

NPI Status: Active since March 29, 2016

Contact Information

13917 W HIGHWAY 71 STE A
AUSTIN, TX
ZIP 78738
Phone: (512) 610-7030
Fax: (512) 610-7034

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with JOEL SARMIENTO, a practicing pediatrics professional in Austin, TX. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 36 individual coverage options managed by medical networks, including networks like Baylor Scott and White Health Plan, Moda Health Plan, Inc., and Sendero Health Plans, Local Nonprofit. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

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Fitler by Network Type

Baylor Scott and White Health Plan

BSW Diabetes Care Gold HMO 014

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460014

BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460001

BSW Elite Gold HMO 004

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460004

BSW Elite Gold HMO 012

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460012

BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460003

BSW Prime Silver HMO 008

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460008

BSW Prime Silver HMO 005

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460005

BSW Savers Bronze HMO H S A 006

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460006

BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460007

BSW Savers Bronze HMO H S A 009

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460009

Moda Health Plan, Inc.

Moda Select Alaska Bronze 6500

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0930003

Moda Select Alaska Bronze HDHP 5500

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0970002

Moda Select Alaska Gold 1500

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0930001

Moda Select Alaska Silver 4500

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0930002

Moda Select Alaska Standard Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0960001

Moda Select Alaska Standard Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0940001

Moda Select Alaska Standard Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

73836AK0950001

Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD)

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

17933TX0010006

Moda Select Texas Bronze HDHP 7500

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

17933TX0010007

Moda Select Texas Standard Bronze

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

17933TX0010010

Moda Select Texas Standard Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

17933TX0010009

Moda Select Texas Standard Silver

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

17933TX0010008

Sendero Health Plans, Local Nonprofit

Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010022

Sendero Health Capital Silver / $40 PCP / $80 Specialist / $20 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010017

Sendero Health Hill Country Gold / $30 PCP / $60 Specialist / $15 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010018

Sendero Health Original Silver / $20 PCP + 2 $0 PCP Visits / $10 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010001

Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010008

Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010020

Sendero Health Real Gold / $350 Deductible

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

71837TX0010002

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does JOEL SARMIENTO accept?

This provider accepts health insurance plans managed by the following insurance companies: Baylor Scott and White Health Plan, Moda Health Plan, Inc., Sendero Health Plans, Local Nonprofit. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

No, current public enrollment indicators show that this provider does not accept standard Medicare program assignments.

What managed care network types are accepted by this provider?

JOEL SARMIENTO is enrolled across the following managed care network types: EPO, HMO, PPO.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.
EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.