DR. JOHN PHILIP MASCIALE M.D.
NPI 1912919119
Orthopaedic Surgery in Corpus Christi, TX

Active since August 13, 2006PECOS EnrolledAccepts Medicare Assignment
63.37/100
CMS Quality Rating
5917 CROSSTOWN EXPRESSWAY SH 286, CORPUS CHRISTI, TX 78417(361) 854-0811(361) 806-5040 Get Directions Write a Review

NPPES record last updated: February 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. John Philip Masciale M.d. NPPES

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

DR. JOHN PHILIP MASCIALE M.D. (NPI 1912919119) is an individual orthopaedic surgery provider in Corpus Christi, Texas, licensed in Texas (H3402) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Christus Spohn Hospital Corpus Christi, and is a graduate of State University Of New York Downstate Medical Center (1985).

NPPES Registry Identity

NPI1912919119
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. JOHN PHILIP MASCIALECredential: M.D.
Location Address5917 CROSSTOWN EXPRESSWAY SH 286Corpus Christi, TX 78417
Mailing Address5917 Crosstown Expressway Sh 286Corpus Christi, TX 78417 · (361) 854-0811 · Fax (361) 806-5040
Fax(361) 806-5040
Sole ProprietorNo
Medical School CMSState University Of New York Downstate Medical CenterGraduated 1985
Enumeration DateAugust 13, 2006
Last NPPES UpdateFebruary 8, 2023
NPPES CertifiedFebruary 8, 2023
NPI 1912919119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in TX · H3402
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedOrthopaedic Surgery · Orthopaedic Surgery of the SpineTaxonomy 207XS0117X · License H3402 (TX)
5917 CROSSTOWN EXPRESSWAY SH 286, Corpus Christi, TX 78417

Other Identifiers 1

Medicaid1176307-02TX

Accepted 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. John Philip Masciale 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 ID8426045493
PECOS Enrollment IDI20040819000241
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 22

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.
417 services222 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
108 services97 patients
X-ray of lower and sacral spine, 2-3 views 72100
An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
93 services46 patients
X-ray lower and sacral spine, minimum of 6 views 72114
An X-ray of the lower and sacral spine involves capturing images of the bones in your lower back and tailbone area. It helps to identify issues like fractures, infections, or degenerative diseases. A minimum of 6 views ensures a comprehensive examination.
74 services74 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.
63 services63 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
61 services57 patients

Hospital Affiliations CMS Care Compare 2

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

Christus Spohn Hospital Corpus Christi

Acute Care Hospitals · Corpus Christi, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450046
Location600 Elizabeth StreetCorpus Christi, TX 78404 · Nueces County
Emergency services Birthing friendly

Corpus Christi Medical Center,the

Acute Care Hospitals · Corpus Christi, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number450788
Location6629 Woodridge RoadCorpus Christi, TX 78414 · Nueces County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78417 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

63.37/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.68
Promoting Interoperability84
Improvement Activities40
Cost27.56

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
27%576 patients2/55-star benchmark: 87%
Controlling High Blood Pressure
2%49 patients1/55-star benchmark: 91%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
72%50 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
53%3,430 patients2/55-star benchmark: 100%
e-Prescribing
99%968 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 8% · 1,247 patients
8%1,247 patients
Provide Patients Electronic Access to Their Health Information
68%714 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
81%129 patients4/55-star benchmark: 91%
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 4

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

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
4 suppliers11 claims11 services$57.23 avg. paid by Medicare
Osteogenesis stimulator, electrical, non-invasive, spinal applications E0748
DME-Other DME · category DE000N
2 suppliers12 claims12 services$3,750.90 avg. paid by Medicare
Cervical, multiple post collar, occipital/mandibular supports, adjustable L0180
DME-Orthotic Devices · category DF000N
1 supplier13 claims13 services$321.59 avg. paid by Medicare
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0650
DME-Orthotic Devices · category DF007N
2 suppliers19 claims19 services$783.00 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 10

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

Internal Medicine (Sports Medicine)
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Physician Assistant
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Orthopaedic Surgery
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Orthopaedic Surgery
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Orthopaedic Surgery
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Orthopaedic Surgery
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Nurse Practitioner (Family)
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417
Physician Assistant (Medical)
5917 CROSSTOWN EXPRESSWAY SH 286
CORPUS CHRISTI, TX 78417

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 John Masciale's NPI number?

The NPI number for John Masciale is 1912919119. It was assigned to this individual provider in the NPPES registry on August 13, 2006.

Where is John Masciale located?

John Masciale practices at 5917 Crosstown Expressway Sh 286, Corpus Christi, TX 78417. The listed phone number is (361) 854-0811.

What is John Masciale's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is John Masciale enrolled in Medicare?

Yes. John Masciale 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 John Masciale accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and UnitedHealthcare list John Masciale 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 John Masciale affiliated with any hospitals?

According to CMS data, John Masciale is affiliated with Christus Spohn Hospital Corpus Christi and Corpus Christi Medical Center,the.

When was this NPI record last updated?

The NPPES record for John Masciale was last updated on February 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.