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DR. ALEX R. ESPINAL M.D.
NPI 1821067034
Surgery in Rock Hill, SC

Active since March 17, 2006PECOS EnrolledAccepts Medicare Assignment
87.26/100
CMS Quality Rating
200 S HERLONG AVE, SUITE G, ROCK HILL, SC 29732(803) 909-6300(803) 909-6310 Get Directions Write a Review

NPPES record last updated: December 20, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Alex R. Espinal M.d. NPPES

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

DR. ALEX R. ESPINAL M.D. (NPI 1821067034) is an individual surgery provider in Rock Hill, South Carolina, licensed in South Carolina (21007) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Medical Center, and is a graduate of Northeastern Ohio University College Of Medicine (1994).

NPPES Registry Identity

NPI1821067034
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. ALEX R. ESPINALCredential: M.D.
Location Address200 S HERLONG AVE, SUITE GRock Hill, SC 29732-3399
Mailing Address200 S Herlong Ave, Suite GRock Hill, SC 29732-3399 · (803) 909-6300 · Fax (803) 909-6310
Phone(803) 909-6300
Fax(803) 909-6310
Sole ProprietorNo
Medical School CMSNortheastern Ohio University College Of MedicineGraduated 1994
Enumeration DateMarch 17, 2006
Last NPPES UpdateDecember 20, 2013
✔ NPI 1821067034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in SC · 21007
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
200 S HERLONG AVE, Rock Hill, SC 29732
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and more.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

Dr. Alex R. Espinal 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 ID4284891722
PECOS Enrollment IDI20120210000268
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 7

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.
102 services71 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.
67 services67 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
31 services31 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
30 services30 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
26 services16 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
23 services22 patients

Hospital Affiliations CMS Care Compare

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

Piedmont Medical Center

Acute Care Hospitals · Rock Hill, SC
2/5 CMS rating
OwnershipProprietary
CMS Certification Number420002
Location1731 Frank Gaston BlvdRock Hill, SC 29732 · York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29732 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
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$67.12 typical visit price
range $16.96 – $133.52
Typical copayment $16.78 (range $4.24 – $33.38)
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.

87.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.61
Promoting Interoperability100
Improvement Activities40
Cost81.93

Reported Quality Measures

Breast Cancer Screening
45%244 patients2/55-star benchmark: 93%
Cervical Cancer Screening
45%387 patients2/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
53%138 patients3/55-star benchmark: 87%
Controlling High Blood Pressure
55%262 patients3/55-star benchmark: 91%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
52%109 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
85%1,617 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
18%270 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
99%967 patients5/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
34%768 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
23%814 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 97% · 857 patients
Patients screened: 98% · 857 patients
96%122 patients4/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 1% · 284 patients
Patients totalRate: 7% · 290 patients
6%290 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 3

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

Ostomy skin barrier, pectin-based, paste, per ounce A4406
DME-Orthotic Devices · category DF010N
2 suppliers15 claims44 services$5.52 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
3 suppliers20 claims560 services$5.77 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
2 suppliers11 claims380 services$2.48 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 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRIAN MIKA MD
Psychiatry & Neurology (Psychiatry)
200 S HERLONG AVE, SUITE C
ROCK HILL, SC 29732
York County (803) 323-2775
ALLAN S. RYDER-COOK M.D.
Psychiatry & Neurology (Neurology)
200 S HERLONG AVE, SUITE H
ROCK HILL, SC 29732
York County (803) 366-6135
DR. CHAD S KESSLER MD
Otolaryngology
200 S HERLONG AVE, SUITE A
ROCK HILL, SC 29732
York County (803) 328-1864
PIEDMONT BEHAVIORAL MEDICINE ASSOCIATES, LLC
Behavior Analyst
200 S HERLONG AVE, SUITE C
ROCK HILL, SC 29732
York County (803) 323-2775
PMC PHYSICIAN NETWORK, L.L.C.
Neurological Surgery
200 S HERLONG AVE, SUITE B
ROCK HILL, SC 29732
York County (803) 327-8500
MARK A. PORTER M.D.
Psychiatry & Neurology (Neurology)
200 S HERLONG AVE, SUITE H
ROCK HILL, SC 29732
York County (803) 366-6135
KIM THIEN NGUYEN HO AU.D.
Audiologist
200 S HERLONG AVE, SUITE A
ROCK HILL, SC 29732
York County (803) 328-1864
DR. SARAH ELIZABETH VAIR AUD
Audiologist
200 S HERLONG AVE, SUITE A
ROCK HILL, SC 29732
York County (803) 328-1864

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 Alex Espinal's NPI number?

The NPI number for Alex Espinal is 1821067034. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Where is Alex Espinal located?

Alex Espinal practices at 200 S Herlong Ave Suite G, Rock Hill, SC 29732. The listed phone number is (803) 909-6300.

What is Alex Espinal's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Alex Espinal enrolled in Medicare?

Yes. Alex Espinal 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 Alex Espinal accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina, First Choice Next and Molina Healthcare and 1 other insurer list Alex Espinal 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 Alex Espinal affiliated with any hospitals?

According to CMS data, Alex Espinal is affiliated with Piedmont Medical Center.

When was this NPI record last updated?

The NPPES record for Alex Espinal was last updated on December 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.