JOSE A FLORES GUEVARA M.D.
NPI 1922006337
Ophthalmology in Saint Cloud, FL
Quality Rating: 84.95 out of 100 score
NPI Status: Active since July 09, 2005
Contact Information
4589 HENRY C. YATES LANE
SAINT CLOUD, FL
ZIP 34769
Phone: (407) 891-2010
Fax: (407) 891-8211
- Individual
- Male
- Ophthalmology
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About JOSE FLORES GUEVARA
This page provides the complete NPI Profile along with additional information for Jose Flores Guevara, a provider established in Saint Cloud, Florida with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1922006337 assigned on July 2005. The practitioner's primary taxonomy code is 207W00000X with license number ME135894 (FL). The provider is registered as an individual and his NPI record was last updated 8 years ago.
- NPI
- 1922006337
- Provider Name
- JOSE A FLORES GUEVARA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 4589 HENRY C. YATES LANE SAINT CLOUD, FL 34769
- Location Phone
- (407) 891-2010
- Location Fax
- (407) 891-8211
- Mailing Address
- 4589 HENRY C. YATES LN SAINT CLOUD, FL 34769
- Mailing Phone
- (407) 891-2010
- Mailing Fax
- (407) 891-8211
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-09-2005
- Last Update Date
- 11-28-2018
- Code Navigator
Ophthalmologists like Jose Flores Guevara specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
Location Map
Secondary Locations
- 1121 Miranda Lane
Kissimmee, FL 34741
(407) 530-5977
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME135894
- License State
- FL
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | 11435 (PR) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? 902 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? 903 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- MyBlue Bronze HMO? 902 - HMO
- MyBlue Bronze HMO? 904 - HMO
- MyBlue Bronze HMO? Standard - HMO
- MyBlue Gold HMO? 704 - HMO
- MyBlue Gold HMO? 804 - HMO
- MyBlue Gold HMO? Standard - HMO
- MyBlue Silver HMO? 705 - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Bronze Classic 4700 - HMO
- Bronze Classic 4700 | with AdventHealth - HMO
- Bronze Classic Standard - HMO
- Bronze Classic Standard | with AdventHealth - HMO
- Bronze Elite + PCP Saver Plus - HMO
- Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
- Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Bronze Simple Chronic Care CKM - HMO
- Bronze Simple Diabetes - HMO
- Gold Classic Standard - HMO
- Gold Classic Standard | with AdventHealth - HMO
- Gold Elite Saver Plus | with AdventHealth - HMO
- Gold Simple - HMO
- Gold Simple | with AdventHealth - HMO
- Silver Classic Standard - HMO
- Silver Classic Standard | with AdventHealth - HMO
- Silver Elite - HMO
- Silver Elite | with AdventHealth - HMO
- Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
- Silver Simple Chronic Care CKM - HMO
- Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Catastrophic (+ Incentives) - HMO
- Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 2000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jose Flores Guevara 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.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 34769 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.04
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $32.51
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.04
- Minimum Established Patient Price $17.57
- Maximum Established Patient Price $139.16
- Average Established Patient Copayment $17.51
- Minimum Established Patient Copayment $4.39
- Maximum Established Patient Copayment $34.79
* The physician office visit costs information is generated by 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 84.95, 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 Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.
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Final Score: 84.95 out of 100
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.
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Quality Score: 62.32
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.
-
Promoting Interoperability Score: 100
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. -
Improvement Activities Score: 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 activities measure category compromises 15% providers final MPIS scores.
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. -
Cost Score: 87.53
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. -
Cost Score: 87.53
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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. 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 |
|---|---|---|
| Diabetes: Eye Exam | 100% | 21 |
| 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 | ||
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1922006337, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922006337, enumerated as an "individual" on July 09, 2005.
The provider is located at 4589 HENRY C. YATES LANE SAINT CLOUD, FL 34769 and the phone number is (407) 891-2010.
Ophthalmology with taxonomy code 207W00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.
