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JOHN M ARCIA MD
NPI 1932198256
Internal Medicine - Nephrology in Burbank, CA

Active since October 19, 2005PECOS EnrolledAccepts Medicare Assignment
255 E ORANGE GROVE AVE, BURBANK, CA 91502(818) 848-5595(818) 848-5576 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 7, 2023, Nov 23, 2015 (2 updates tracked since 2015).

About John M Arcia Md NPPES

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

JOHN M ARCIA MD (NPI 1932198256) is an individual nephrology provider in Burbank, California, licensed in California (E70558) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Diego School Of Medicine (1989).

NPPES Registry Identity

NPI1932198256
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameJOHN M ARCIACredential: MD
Location Address255 E ORANGE GROVE AVEBurbank, CA 91502-1240
Mailing Address255 E Orange Grove AveBurbank, CA 91502-1240 · (818) 848-5595 · Fax (818) 484-2176
Phone(818) 848-5595
Fax(818) 848-5576
Sole ProprietorNo
Medical School CMSUniversity Of California, San Diego School Of MedicineGraduated 1989
Enumeration DateOctober 19, 2005
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1932198256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in CA · E70558
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

255 E ORANGE GROVE AVE, Burbank, CA 91502
Open in Google Maps ↗

Other Identifiers 2

OtherG70558CA · Lic
MedicaidGR0069980CA

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

John M Arcia 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 ID749305985
PECOS Enrollment IDI20100913000222
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 12

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.
2,347 services373 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.
685 services271 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
403 services71 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.
381 services271 patients
Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458
This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.
196 services14 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
184 services72 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91502 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
81%177 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
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.
96%1,869 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%47 patients5/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
89%167 patients4/55-star benchmark: 96%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
29%676 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
0%955 patients1/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
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
Patients tobacco: 93% · 532 patients
96%532 patients
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
75%832 patients4/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 466 patients
0%466 patients5/55-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 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers22 claims54 services$6.63 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers14 claims18 services$1.20 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers30 claims4,680 services$0.26 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
4 suppliers29 claims29 services$16.96 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
4 suppliers12 claims15 services$12.56 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 6

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

YVONNE MAO MD
Internal Medicine (Nephrology)
255 E ORANGE GROVE AVE, STE D
BURBANK, CA 91502
Los Angeles County (818) 848-5595
DINA SAN GABRIEL D.M.D.
Dentist
255 E ORANGE GROVE AVE, SUITE B
BURBANK, CA 91502
Los Angeles County (818) 557-0964
ERIK V SITKER MD
Internal Medicine (Nephrology)
255 E ORANGE GROVE AVE, SUITE D
BURBANK, CA 91502
Los Angeles County (818) 848-5595
DANIEL LEVITAN MD INC
Internal Medicine (Nephrology)
255 E ORANGE GROVE AVE, STE D
BURBANK, CA 91502
Los Angeles County (818) 848-5595
SAN GABRIEL SUMMIT DENTAL, INC.
Dentist (General Practice)
255 E ORANGE GROVE AVE, SUITE B
BURBANK, CA 91502
Los Angeles County (818) 557-0964
HENRY GLEED NEBEKER MD
Internal Medicine (Nephrology)
255 E ORANGE GROVE AVE, STE D
BURBANK, CA 91502
Los Angeles County (818) 848-5595

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 Arcia's NPI number?

The NPI number for John Arcia is 1932198256. It was assigned to this individual provider in the NPPES registry on October 19, 2005.

Where is John Arcia located?

John Arcia practices at 255 E Orange Grove Ave, Burbank, CA 91502. The listed phone number is (818) 848-5595.

What is John Arcia's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is John Arcia enrolled in Medicare?

Yes. John Arcia 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.

When was this NPI record last updated?

The NPPES record for John Arcia was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.