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PNEUMA G. ORTEGA MD
NPI 1912167834
Family Medicine in San Jose, CA

Active since June 13, 2008PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
2820 ALUM ROCK AVE STE 20, SAN JOSE, CA 95127(408) 729-2900 Get Directions Write a Review

NPPES record last updated: July 27, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 27, 2026, Nov 20, 2023, Mar 31, 2021 (3 updates tracked since 2021).

About Pneuma G. Ortega Md NPPES

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

PNEUMA G. ORTEGA MD (NPI 1912167834) is an individual family medicine provider in San Jose, California, licensed in California (A101636) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1912167834
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePNEUMA G. ORTEGACredential: MD
Location Address2820 ALUM ROCK AVE STE 20San Jose, CA 95127-5608
Mailing Address2820 Alum Rock Ave Ste 20San Jose, CA 95127-5608 · (408) 729-2900
Phone(408) 729-2900
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateJune 13, 2008
Last NPPES UpdateJuly 27, 20263 updates tracked since enumeration
NPPES CertifiedJuly 27, 2026
✔ NPI 1912167834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A101636
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2820 ALUM ROCK AVE STE 20, San Jose, CA 95127
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pneuma G. Ortega 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 ID4587736657
PECOS Enrollment IDI20080707000365, I20231025002671
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.

Medicare Billing Reassignments

7

Medicare enrollment records show Pneuma Ortega reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Top Care Medical Group Inc
Same address
Family Medicine
2820 ALUM ROCK AVE STE 20
San Jose, CA 95127
  • Reassigned Medicare billing, California enrollment
  • 9 clinicians in this Medicare group
NPI 1932665437 (408) 307-0560
County Of Santa Clara
0.9 mi
Federally Qualified Health Center (FQHC)
2101 ALEXIAN DR
San Jose, CA 95116
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1326033929 (California), NPI 1043354020 (California)
  • 1,232 clinicians in this Medicare group
NPI 1629301346 (408) 885-5000
Emergency Physicians Associates San Jose PC
6.2 mi
Emergency Medicine
2105 FOREST AVE
San Jose, CA 95128
  • Reassigned Medicare billing, California enrollment
  • 197 clinicians in this Medicare group
NPI 1306311576 (408) 947-2500
Lakeview Medical Center Inc Of Rice Lake
1,648 mi
Clinic/Center
1700 W STOUT ST
Rice Lake, WI 54868
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,616 clinicians in this Medicare group
NPI 1093201832 (715) 236-6133
Mchs Hospitals Inc
1,653 mi
Clinic/Center
2310 CRAIG RD
Eau Claire, WI 54701
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1952890873 (Wisconsin)
  • 2,476 clinicians in this Medicare group
NPI 1316416035 (715) 858-8100
Flambeau Hospital Inc
1,716 mi
Clinic/Center
98 SHERRY AVE
Park Falls, WI 54552
  • Reassigned Medicare billing, Wisconsin enrollment
  • Also billed through NPI 1700963048 (Wisconsin)
  • 1,351 clinicians in this Medicare group
NPI 1194317966 (715) 762-2484
Marshfield Clinic Inc
1,717 mi
Clinic/Center
1000 N OAK AVE
Marshfield, WI 54449
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,540 clinicians in this Medicare group
NPI 1952347981 (715) 387-5511

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.
556 services286 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
150 services89 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
35 services11 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.
23 services22 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.
11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95127 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
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality95.25
Promoting Interoperability100
Improvement Activities40

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$19.33 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
2 suppliers23 claims23 services$108.88 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
1 supplier12 claims12 services$35.00 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 2

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

LAS COLINAS MEDICAL GROUP, INC.
Clinic/Center (Primary Care)
2820 ALUM ROCK AVE STE 20
SAN JOSE, CA 95127
Santa Clara County (408) 729-2900
TOP CARE MEDICAL GROUP INC
Family Medicine
2820 ALUM ROCK AVE STE 20
SAN JOSE, CA 95127
Santa Clara County (408) 307-0560

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 Pneuma Ortega's NPI number?

The NPI number for Pneuma Ortega is 1912167834. It was assigned to this individual provider in the NPPES registry on June 13, 2008.

Where is Pneuma Ortega located?

Pneuma Ortega practices at 2820 Alum Rock Ave Ste 20, San Jose, CA 95127. The listed phone number is (408) 729-2900.

What is Pneuma Ortega's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Pneuma Ortega enrolled in Medicare?

Yes. Pneuma Ortega 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.

Which organizations bill Medicare for Pneuma Ortega's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pneuma Ortega reassigns Medicare benefits to 7 organizations: Top Care Medical Group Inc (San Jose, CA), County Of Santa Clara (San Jose, CA), Emergency Physicians Associates San Jose PC (San Jose, CA), Lakeview Medical Center Inc Of Rice Lake (Rice Lake, WI), Mchs Hospitals Inc (Eau Claire, WI) and 2 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pneuma Ortega's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Pneuma Ortega was last updated on July 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.