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TERESA C IRIBARREN MD
NPI 1861439093
Internal Medicine in Miami, FL

Active since May 31, 2006PECOS EnrolledAccepts Medicare Assignment
12955 SW 42ND ST, SUITE 12, MIAMI, FL 33175(305) 226-5106(305) 226-5105 Get Directions Write a Review

NPPES record last updated: April 24, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Teresa C Iribarren Md NPPES

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

TERESA C IRIBARREN MD (NPI 1861439093) is an individual internal medicine provider in Miami, Florida, licensed in Florida (79837) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Doctors Hospital, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1861439093
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameTERESA C IRIBARRENCredential: MD
Location Address12955 SW 42ND ST, SUITE 12Miami, FL 33175-2902
Mailing Address12955 Sw 42nd St, Suite 12Miami, FL 33175-2902 · (305) 226-5106 · Fax (305) 226-5105
Phone(305) 226-5106
Fax(305) 226-5105
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateMay 31, 2006
Last NPPES UpdateApril 24, 2013
✔ NPI 1861439093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · 79837
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12955 SW 42ND ST, Miami, FL 33175
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Other Names 1

Former Name (1)Teresa C Iribarren Md Pa

Other Identifiers 8

Other297125FL · Avmed
Other8267932FL · Cigna
Medicaid278113100FL
Medicare PINE8592XFL
Medicare UPINH74463
Other006M4FL · Preferred Care Partners
Other170460FL · Humana
Other92269FL · Bcbs Fl

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), Oscar Health Maintenance Organization of Florida 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

Teresa C Iribarren Md 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 ID2163476045
PECOS Enrollment IDI20050303000951
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 4

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.
88 services36 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
32 services31 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
28 services28 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
22 services15 patients

Hospital Affiliations CMS Care Compare

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

Doctors Hospital

Acute Care Hospitals · Coral Gables, FL
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number100296
Location5000 University DrCoral Gables, FL 33146 · Miami-Dade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33175 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
Most-billed visit code 99214
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%28 patients5/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
100%21 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%31 patients5/55-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.

Other Providers at the Same Location NPPES 6

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

TERESA C IRIBARREN MD PA
Specialist
12955 SW 42ND ST, SUITE 12
MIAMI, FL 33175
Miami-Dade County (305) 226-5106
COMPLETE MEDICAL CARE ASSOCIATES, INC
Health Maintenance Organization
12955 SW 42ND ST, SUITE 10
MIAMI, FL 33175
Miami-Dade County (305) 554-0079
ROBERT A ZURAWIECKI MD PA
Internal Medicine
12955 SW 42ND ST, SUITE 10
MIAMI, FL 33175
Miami-Dade County (305) 554-0079
VICENTE RODRIGUEZ M D P A
Psychiatry & Neurology (Geriatric Psychiatry)
12955 SW 42ND ST, SUITE 12
MIAMI, FL 33175
Miami-Dade County (305) 383-6200
ADAN HOME HEALTH CARE, INC
Home Health
12955 SW 42ND ST, SUITE 109
MIAMI, FL 33175
Miami-Dade County (305) 643-0666
ANGEL HOME CARE SERVICES, INC.
Home Health
12955 SW 42ND ST, SUITE 104
MIAMI, FL 33175
Miami-Dade County (305) 220-4544

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 Teresa Iribarren's NPI number?

The NPI number for Teresa Iribarren is 1861439093. It was assigned to this individual provider in the NPPES registry on May 31, 2006. The provider is also known as Teresa C Iribarren MD PA.

Where is Teresa Iribarren located?

Teresa Iribarren practices at 12955 SW 42nd St Suite 12, Miami, FL 33175. The listed phone number is (305) 226-5106.

What is Teresa Iribarren's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Teresa Iribarren enrolled in Medicare?

Yes. Teresa Iribarren 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 Teresa Iribarren accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Teresa Iribarren 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 Teresa Iribarren affiliated with any hospitals?

According to CMS data, Teresa Iribarren is affiliated with Doctors Hospital.

When was this NPI record last updated?

The NPPES record for Teresa Iribarren was last updated on April 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.