JOEL SARMIENTO
Accepted Insurance for NPI 1790148708
Pediatrics in Austin, TX
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
JOEL SARMIENTO, a pediatrics provider in Austin, TX, is listed as in-network for 36 health insurance plans from 3 insurance companies, led by Moda Health Plan, Inc., Baylor Scott and White Health Plan and Sendero Health Plans, Local Nonprofit. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
Baylor Scott and White Health Plan
BSW Diabetes Care Gold HMO 014
BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay)
BSW Elite Gold HMO 004
BSW Elite Gold HMO 012
BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay)
BSW Prime Silver HMO 008
BSW Prime Silver HMO 005
BSW Savers Bronze HMO H S A 006
BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay)
BSW Savers Bronze HMO H S A 009
Moda Health Plan, Inc.
Moda Select Alaska Bronze 6500
Moda Select Alaska Bronze HDHP 5500
Moda Select Alaska Gold 1500
Moda Select Alaska Silver 4500
Moda Select Alaska Standard Bronze
Moda Select Alaska Standard Gold
Moda Select Alaska Standard Silver
Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD)
Moda Select Texas Bronze HDHP 7500
Moda Select Texas Standard Bronze
Moda Select Texas Standard Gold
Moda Select Texas Standard Silver
Sendero Health Plans, Local Nonprofit
Sendero Health Austin512 Silver / $40 PCP / $75 Specialist / $15 Generic Drugs / $0 Deductible
Sendero Health Capital Silver / $40 PCP / $80 Specialist / $20 Generic Drugs
Sendero Health Hill Country Gold / $30 PCP / $60 Specialist / $15 Generic Drugs
Sendero Health Original Silver / $20 PCP + 2 $0 PCP Visits / $10 Generic Drugs
Sendero Health Preferred Bronze / $25 PCP / $75 Specialist / $22 Generic Drugs
Sendero Health Quality Care Bronze High Deductible / $50 PCP / $25 Generic Drugs / $100 Specialist
Sendero Health Real Gold / $350 Deductible
Coverage Questions FAQs
Common questions about this provider’s insurance participation, answered from the CMS Health Insurance Marketplace and Medicare enrollment files.
What insurance does JOEL SARMIENTO accept?
Marketplace files for the 2026 plan year list JOEL SARMIENTO as in-network for 36 plans from 3 insurance companies. The largest networks are Moda Health Plan, Inc. (12 plans), Baylor Scott and White Health Plan (10 plans), Sendero Health Plans, Local Nonprofit (7 plans). The full list above shows each plan's metal level, network type, and plan IDs.
Is JOEL SARMIENTO enrolled in Medicare?
The CMS Medicare enrollment files linked to this NPI do not currently show a Medicare assignment or PECOS enrollment indicator. Registry files can lag recent enrollment changes, so verify Medicare participation directly with the practice.
What network types does JOEL SARMIENTO participate in?
The accepted plans include 17 HMO plans, 7 PPO plans and 5 EPO plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists. PPO (Preferred Provider Organization) plans cover out-of-network care at a higher cost and do not require referrals. EPO (Exclusive Provider Organization) plans cover network providers only, generally without referral requirements.
Where does this insurance data come from and how current is it?
Plan participation is compiled from the official CMS Health Insurance Marketplace public use files for the 2026 plan year and refreshed as CMS publishes updated files. Networks change during the year, so always verify coverage with the insurance company or the provider's office before scheduling care.
