DR. JUAN MANUEL ORTIZ M.D.
NPI 1881621431
Internal Medicine - Pulmonary Disease in Edinburg, TX

Q: What is Juan Ortiz's NPI number?

The NPI number for Juan Ortiz is 1881621431. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Q: What is Juan Ortiz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Juan Ortiz was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since June 27, 2006PECOS EnrolledAccepts Medicare Assignment

87.38/100

CMS Quality Rating

5501 S MCCOLL RD, EDINBURG, TX 78539(956) 362-8677(956) 362-7253 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 5, 2025, Feb 13, 2025, Oct 31, 2018 (3 updates tracked since 2018).

On this page

About Dr. Juan Manuel Ortiz M.d. NPPES

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

DR. JUAN MANUEL ORTIZ M.D. (NPI 1881621431) is an individual pulmonary disease provider in Edinburg, Texas, licensed in Texas (L6134) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Starr County Memorial Hospital, and is a graduate of University Of Missouri, Columbia School Of Medicine (1985).

NPPES Registry Identity

NPI1881621431

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. JUAN MANUEL ORTIZCredential: M.D.

Location Address5501 S MCCOLL RDEdinburg, TX 78539-5503

Mailing AddressPo Box 6148Mcallen, TX 78502-6148 · (956) 362-8677 · Fax (956) 362-7253

Phone(956) 362-8677

Fax(956) 362-7253

Sole ProprietorNo

Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 1985

Enumeration DateJune 27, 2006

Last NPPES UpdateJune 5, 20253 updates tracked since enumeration

NPPES CertifiedJune 5, 2025

✔ NPI 1881621431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in TX · L6134

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License L6134 (TX)

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License L6134 (TX)

5501 S MCCOLL RD, Edinburg, TX 78539

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Other Identifiers 1

Medicaid158052402TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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. Juan Manuel Ortiz 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 ID9234108838

PECOS Enrollment IDI20040930000244

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 16

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 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

449 services135 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.

158 services98 patients

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.

150 services104 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.

139 services56 patients

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.

88 services79 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

86 services83 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

66 services65 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

53 services25 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.

44 services41 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

40 services40 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

37 services37 patients

Ultrasound scan of chest 76604

An ultrasound scan of the chest is a non-invasive imaging procedure that uses sound waves to create pictures of the structures within your chest, such as your heart and lungs. It's a safe, painless method that helps doctors diagnose and monitor various conditions.

17 services12 patients

Test for exercise-induced lung stress 94618

An exercise-induced lung stress test assesses how your lungs respond to physical activity. During the test, you'll exercise on a treadmill or stationary bike while your heart rate, breathing, blood pressure, and oxygen levels are monitored. This helps identify any abnormal lung responses to exercise.

13 services12 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.

13 services13 patients

Insertion of non-tunneled central venous tube for infusion (5 years or older) 36556

This procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.

11 services11 patients

Therapy procedure using a positive pressure ventilator 94660

A positive pressure ventilator is a device that helps with breathing. It pushes air into the lungs to assist in maintaining oxygen levels. This can be essential for patients with conditions that affect their ability to breathe independently. It's non-invasive and comfortable.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Starr County Memorial Hospital

Acute Care Hospitals · Rio Grande City, TX

OwnershipGovernment - Hospital District or Authority

CMS Certification Number450654

Location128 N Fm Rd 3167Rio Grande City, TX 78582 · Starr County

Emergency services Birthing friendly

Valley Regional Medical Center

Acute Care Hospitals · Brownsville, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450662

Location100 A Alton GloorBrownsville, TX 78526 · Cameron County

Emergency services Birthing friendly

Doctors Hosptal At Renaissance

Acute Care Hospitals · Edinburg, TX

3/5 CMS rating

OwnershipPhysician

CMS Certification Number450869

Location5501 South MccollEdinburg, TX 78539 · Hidalgo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78539 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

87.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

62.14

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Advance Care Plan

69%1,981 patients3/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

20%177 patients1/55-star benchmark: 87%

Colorectal Cancer Screening

2%1,722 patients1/55-star benchmark: 88%

Controlling High Blood Pressure

50%482 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

1%237 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

100%237 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

95%4,958 patients4/55-star benchmark: 100%

e-Prescribing

96%1,534 patients3/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

7%1,389 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

26%2,826 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

16%3,158 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 94% · 2,089 patients

Patients screened: 97% · 2,089 patients

48%144 patients2/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

56%1,395 patients3/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

89%562 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 1,466 patients

Patients totalRate: 1% · 1,468 patients

1%1,468 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 35

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

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

8 suppliers165 claims166 services$30.91 avg. paid by Medicare

Tracheal suction catheter, closed system, each A4605

DME-Other DME · category DE000N

1 supplier12 claims120 services$15.85 avg. paid by Medicare

Tracheal suction catheter, any type other than closed system, each A4624

DME-Other DME · category DE000N

1 supplier12 claims1,080 services$2.55 avg. paid by Medicare

Oropharyngeal suction catheter, each A4628

DME-Other DME · category DE000N

2 suppliers24 claims48 services$3.54 avg. paid by Medicare

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

1 supplier12 claims360 services$4.50 avg. paid by Medicare

Canister, disposable, used with suction pump, each A7000

DME-Other DME · category DE000N

2 suppliers24 claims88 services$7.14 avg. paid by Medicare

Tubing, used with suction pump, each A7002

DME-Other DME · category DE000N

2 suppliers23 claims136 services$3.15 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

11 suppliers169 claims170 services$71.30 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

9 suppliers152 claims417 services$27.67 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

6 suppliers88 claims449 services$15.01 avg. paid by Medicare

Pillow for use on nasal cannula type interface, replacement only, pair A7033

DME-Other DME · category DE001N

9 suppliers53 claims248 services$12.16 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

10 suppliers134 claims135 services$44.44 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

13 suppliers185 claims185 services$15.12 avg. paid by Medicare

Chinstrap used with positive airway pressure device A7036

DME-Other DME · category DE001N

5 suppliers11 claims11 services$8.74 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

11 suppliers133 claims133 services$10.15 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

15 suppliers327 claims1,697 services$1.81 avg. paid by Medicare

Filter, non disposable, used with positive airway pressure device A7039

DME-Other DME · category DE001N

7 suppliers40 claims40 services$5.36 avg. paid by Medicare

Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046

DME-Other DME · category DE001N

12 suppliers120 claims120 services$10.76 avg. paid by Medicare

Tracheostomy tube collar/holder, each A7526

DME-Orthotic Devices · category DF000N

3 suppliers29 claims835 services$3.24 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier11 claims341 services$2.79 avg. paid by Medicare

Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154

Other-Enteral and Parenteral · category OB006N

1 supplier11 claims6,050 services$0.58 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers81 claims87 services$14.73 avg. paid by Medicare

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466

DME-Other DME · category DE005N

2 suppliers19 claims19 services$904.79 avg. paid by Medicare

Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) E0470

DME-Other DME · category DE001N

3 suppliers34 claims35 services$81.61 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

4 suppliers96 claims103 services$11.48 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

6 suppliers34 claims42 services$3.72 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

6 suppliers161 claims171 services$28.95 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

6 suppliers210 claims215 services$69.88 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers60 claims60 services$30.98 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

1 supplier17 claims990 services$4.68 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

9 suppliers34 claims6,422 services$0.03 avg. paid by Medicare

Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620

DME-Drugs Administered Through DME · category DG006N

3 suppliers18 claims2,310 services$0.09 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

6 suppliers43 claims2,331 services$0.82 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

2 suppliers25 claims25 services$34.15 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

13 suppliers88 claims88 services$24.57 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 20

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

MR. ADOLFO ARTEAGA APRN-CNP

Nurse Practitioner (Acute Care)

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 362-8677

HENRIETTA J PEYNADO MSN,RN,FNP-BC,OCN

Nurse Practitioner (Family)

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 362-3780

DR. AMINADAB GODINA FLORES MD

Student in an Organized Health Care Education/Training Program

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 249-2739

MARIA SOSA

Specialist/Technologist, Other (Surgical Technologist)

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 362-7451

SALMAN BANGASH MD

Internal Medicine

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 362-3575

DR. MATTHEW BRADLEY WATSON CRNA

Nurse Anesthetist, Certified Registered

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (867) 795-6362

ASMA SALIH MOHAMMED TARJMANI

Internal Medicine

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 369-5100

DAY SURGERY AT RENAISSANCE,LLC

Physician Assistant

5501 S MCCOLL RD
EDINBURG, TX 78539

Hidalgo County (956) 362-3300

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 Juan Ortiz's NPI number?

The NPI number for Juan Ortiz is 1881621431. It was assigned to this individual provider in the NPPES registry on June 27, 2006.

Where is Juan Ortiz located?

Juan Ortiz practices at 5501 S Mccoll Rd, Edinburg, TX 78539. The listed phone number is (956) 362-8677.

What is Juan Ortiz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Juan Ortiz enrolled in Medicare?

Yes. Juan Ortiz 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 Juan Ortiz accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Juan Ortiz 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 Juan Ortiz affiliated with any hospitals?

According to CMS data, Juan Ortiz is affiliated with Starr County Memorial Hospital, Valley Regional Medical Center and Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Juan Ortiz was last updated on June 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.