MISS MARIA T VALDES MD NPI 1902890809
Internal Medicine - Gastroenterology in Naples, FL
- NPI Profile Information
- Primary Taxonomy
- Accepted Insurance
- PECOS Enrollment and Medicare Participation Status
- Physician Office Visit Costs
- Overall MIPS Quality Performance
- Quality Reporting
- Clinician Utilization
- Hospital Affiliations
- Secondary Taxonomies
- NPI Validation
- Other Providers Same Location
About MISS MARIA T VALDES MD
Maria Valdes is an internist established in Naples, Florida and her medical specialization is Internal Medicine with a focus in gastroenterology with more than 33 years of experience. The NPI number of this provider is 1902890809 and was assigned on September 2005. The practitioner's primary taxonomy code is 207RG0100X with license number ME72022 (FL). The provider is registered as an individual and her NPI record was last updated 3 years ago.
| NPI | 1902890809 |
| Provider Name | MISS MARIA T VALDES MD |
| Location Address | 6101 PINE RIDGE RD NAPLES, FL 34119 |
| Location Phone | (239) 348-4509 |
| Mailing Address | 6101 PINE RIDGE RD NAPLES, FL 34119 |
| Gender | Female |
| NPI Entity Type | Individual |
| Medical School Name | OTHER |
| Graduation Year | 1991 |
| Is Sole Proprietor? | No |
| Enumeration Date | 09-07-2005 |
| Last Update Date | 09-23-2020 |
An internist like Maria Valdes is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.Maria Valdes is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Maria Valdes is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Physicians Regional Medical Center - Pine Ridge.
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 90.53, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The following quality measures were reported for this provider: breast cancer screening, chronic care and preventative care management for empaneled patients, colorectal cancer screening, diabetes: eye exam, documentation of current medications in the medical record, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, preventive care and screening: tobacco use: screening and cessation intervention and use of decision support and standardized treatment protocols.
The typical physician office visit costs for Medicare beneficiaries in this area are: $35.38 for a new patient copayment and $27.09 for an established patient copayment.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 207RG0100X |
| Classification | Internal Medicine |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Gastroenterology |
| License No. | ME72022 |
| License State | FL |
| Taxonomy Description | An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
6101 PINE RIDGE RD
NAPLES, FL
ZIP 34119
Phone: (239) 348-4509
Fax: (239) 348-4529
Mailing Address
6101 PINE RIDGE RD
NAPLES, FL
ZIP 34119
Phone: (239) 348-4509
Fax: (239) 348-4529
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 1951380393 |
| PECOS Enrollment ID | I20060413000270 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 34119 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $61.36 | $187 | $141.52 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $15.34 | $46.75 | $35.38 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99214 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $18.68 | $151.65 | $108.36 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.67 | $37.91 | $27.09 |
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
| MIPS Measure | Score Weight | Score | |
|---|---|---|---|
| Quality | 40% | 81.78 | |
|
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores. There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey. |
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| Promoting Interoperability (PI) | 25% | 98.8 | |
|
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores. The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. |
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| Improvement Activities | 15% | 40 | |
|
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. |
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| Cost | 20% | N/A | |
|
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services. Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. |
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| MIPS Final Score | - | 90.53 | |
| The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment. | |||
Quality Reporting
The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 27% | 203 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Colorectal Cancer Screening | 86% | 339 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Diabetes: Eye Exam | 15% | 27 |
| Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
| Documentation of Current Medications in the Medical Record | 100% | 986 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 88% | 225 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 122Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
- 67Biopsy of large bowel using an endoscope (HCPCS:45380)
- 32Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)
- 22Diagnostic examination of large bowel using an endoscope (HCPCS:45378)
- 16Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
- 13Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43235)
Hospital Affiliations
Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Maria Valdes is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | CMS Certification Number (CCN) | Overall Rating |
|---|---|---|---|---|---|
| PHYSICIANS REGIONAL MEDICAL CENTER - PINE RIDGE | 6101 PINE RIDGE ROAD NAPLES, FL 34119 | (239) 348-4000 | Acute Care Hospitals | 100286 |
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 205635-1 | NY | No |
Taxonomy Description: an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 16159V | OTHER (01) | FL | MEDICARE PTAN |
| 272783800 | MEDICAID (05) | FL |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 0 | 2 | 8 | 9 | 0 | 8 | 0 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 0 | 2 | 16 | 9 | 0 | 8 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 0 + 2 + 1 + 6 + 9 + 0 + 8 + 0 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1902890809 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1457347973 | MR. RICHARD S VALLETTE R.PH. Individual | Pharmacist | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4449 |
| 1508840265 | DR. CHRISTOPHER G HAMANN MD Individual | Emergency Medicine | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-9303 |
| 1932183696 | DR. JOHN W ZELAHY MD Individual | Emergency Medicine | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-9303 |
| 1679558902 | DR. ROBERT E WEBER MD Individual | Emergency Medicine | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-9303 |
| 1831175538 | MRS. RENEE J ZAWISTOWSKI RPH PHARM D Individual | Pharmacist | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 304-4780 |
| 1326098336 | ELISABETH KRUPP CRNA Individual | Nurse Anesthetist, Certified Registered | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1780635201 | ARNOLD G ALEXANDER M.D Individual | Internal Medicine | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1730130196 | MYLES L. ALPERT DO Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 304-4862 |
| 1104877307 | DR. JOHN N TROBAUGH MD Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1033160221 | DR. DAVID GRAHAM WHALLEY MD Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 304-4862 |
| 1538110655 | MARC KAYE MD Individual | Radiology (Diagnostic Radiology) | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1073564191 | DEBORAH D. COOPER M.D Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 304-4862 |
| 1922059005 | MICHAEL FINKEL M.D. Individual | Psychiatry & Neurology (Neurology) | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1285685222 | LEONARD SCHLOSSBERG M.D Individual | Internal Medicine | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1861443707 | TERRY A KING Individual | Surgery (Vascular Surgery) | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1962454454 | MITCHELL ZEITLER MD Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1093767030 | CHAD J PURDOM M.D Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1114979085 | ROBERT WAGAR MD Individual | Internal Medicine | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
| 1952353823 | FREDERICK K TORRES MD Individual | Anesthesiology | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 304-4862 |
| 1134173255 | BETSY OPYT R.D Individual | Dietitian, Registered | 6101 PINE RIDGE RD NAPLES, FL 34119 (239) 348-4000 |
Frequently Asked Questions
What is Miss Maria Valdes MD NPI number?
The NPI number assigned to this healthcare provider is 1902890809, registered as an "individual" on September 07, 2005
Where is Miss Maria Valdes MD located?
The provider is located at 6101 Pine Ridge Rd Naples, Fl 34119 and the phone number is (239) 348-4509
Which is Miss Maria Valdes MD specialty?
The provider's speciality is Internal Medicine with a focus in Gastroenterology
How many years of experience does Miss Maria Valdes MD have?
The provider has more than 33 years of experience.
What insurance does Miss Maria Valdes MD accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Is Miss Maria Valdes MD registered in PECOS?
Yes, as of September 14, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What are Miss Maria Valdes MD Quality Ratings?
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
How much is a visit to Miss Maria Valdes MD?
Medicare beneficiaries should expect a typical cost of $141.52 with an average copayment of $35.38 for new patient appointments. Established patients should expect a typical charge of $108.36 and an average copayment of 27.09. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Miss Maria Valdes MD?
The most common procedures or services performed by this practitioner are: Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope, Biopsy of large bowel using an endoscope, Removal of polyps or growths of large bowel using an endoscope, Diagnostic examination of large bowel using an endoscope, Colorectal cancer screening; colonoscopy on individual at high risk and Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope.
Is Miss Maria Valdes MD affiliated to any hospitals?
The practitioner is affiliated to the following hospitals: PHYSICIANS REGIONAL MEDICAL CENTER - PINE RIDGE. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
How do I update my NPI information?
The NPI record of Miss Maria Valdes MD was last updated on September 07, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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