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BLERINA BEGOLLI M.D.
NPI 1831253061
Surgery in Panama City, FL

Active since December 21, 2006PECOS EnrolledAccepts Medicare Assignment
90.84/100
CMS Quality Rating
619 N COVE BLVD, PANAMA CITY, FL 32401(850) 913-6960(850) 913-6961 Get Directions Write a Review

NPPES record last updated: May 7, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Blerina Begolli M.d. NPPES

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

BLERINA BEGOLLI M.D. (NPI 1831253061) is an individual surgery provider in Panama City, Florida, licensed in Florida (ME126480) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS, is affiliated with Ascension Sacred Heart Bay, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1831253061
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameBLERINA BEGOLLICredential: M.D.
Location Address619 N COVE BLVDPanama City, FL 32401-3642
Mailing Address4205 Belfort Rd Ste 4015Jacksonville, FL 32216-3623 · (904) 450-6014
Phone(850) 913-6960
Fax(850) 913-6961
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateDecember 21, 2006
Last NPPES UpdateMay 7, 2020
NPPES CertifiedMay 7, 2020
✔ NPI 1831253061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in FL · ME126480✔ Licensed in FL · TRN4821
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.
619 N COVE BLVD, Panama City, FL 32401
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare 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

Blerina Begolli 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 ID8022309913
PECOS Enrollment IDI20160623001988
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 6

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.

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.
64 services34 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
58 services30 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
57 services25 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.
27 services27 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
27 services27 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Ascension Sacred Heart Bay

Acute Care Hospitals · Panama City, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100026
Location615 N Bonita AvePanama City, FL 32401 · Bay County
Emergency services

Sacred Heart Hospital On The Emerald Coast

Acute Care Hospitals · Miramar Beach, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number100292
Location7800 Us Hwy 98 WMiramar Beach, FL 32550 · Walton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32401 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

90.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.68
Promoting Interoperability100
Improvement Activities40

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.

MRS. ELIZABETH RUTH DOSS ARNP
Nurse Practitioner (Acute Care)
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 913-6960
KATHARINA PELLEGRIN M.D.
Surgery
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 913-6960
KELLY DUANE CARTER M.D.
Pediatrics
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 804-3870
SHAMON A LOCKHART
Behavior Technician
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 270-8411
BRANDY JEAN MCIVER NP-C
Nurse Practitioner (Family)
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 785-9559
DR. REBECCA SUZANNE HYSONG M.D.
Surgery
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 913-6960
LYNN S SETO M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 785-9559
DAVID L TENNISWOOD MD
Surgery
619 N COVE BLVD
PANAMA CITY, FL 32401
Bay County (850) 913-6960

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 Blerina Begolli's NPI number?

The NPI number for Blerina Begolli is 1831253061. It was assigned to this individual provider in the NPPES registry on December 21, 2006.

Where is Blerina Begolli located?

Blerina Begolli practices at 619 N Cove Blvd, Panama City, FL 32401. The listed phone number is (850) 913-6960.

What is Blerina Begolli's specialty?

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

Is Blerina Begolli enrolled in Medicare?

Yes. Blerina Begolli 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 Blerina Begolli accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and Oscar Health Maintenance Organization of Florida list Blerina Begolli 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 Blerina Begolli affiliated with any hospitals?

According to CMS data, Blerina Begolli is affiliated with Ascension Sacred Heart Bay and Sacred Heart Hospital On The Emerald Coast.

When was this NPI record last updated?

The NPPES record for Blerina Begolli was last updated on May 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.