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CARLOS ANDRES NIETO FONSECA MD
NPI 1932367646
Internal Medicine in Pittsburgh, PA

Active since May 29, 2008PECOS EnrolledAccepts Medicare Assignment
200 LOTHROP ST, PITTSBURGH, PA 15213(570) 259-7944 Get Directions Write a Review

NPPES record last updated: August 26, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Carlos Andres Nieto Fonseca Md NPPES

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

CARLOS ANDRES NIETO FONSECA MD (NPI 1932367646) is an individual internal medicine provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MT191305) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, is affiliated with Christus Santa Rosa Medical Center, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1932367646
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameCARLOS ANDRES NIETO FONSECACredential: MD
Location Address200 LOTHROP STPittsburgh, PA 15213-2536
Mailing Address10 Allegheny Ctr Apt 805Pittsburgh, PA 15212-5225 · (570) 259-7944
Phone(570) 259-7944
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMay 29, 2008
Last NPPES UpdateAugust 26, 2010
✔ NPI 1932367646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in PA · MT191305✔ Licensed in PA · MD440423
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
200 LOTHROP ST, Pittsburgh, PA 15213
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Molina Healthcare.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

Carlos Andres Nieto Fonseca 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 ID4880881887
PECOS Enrollment IDI20141014000408
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 4

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.
367 services131 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
177 services159 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.
157 services145 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
154 services89 patients

Hospital Affiliations CMS Care Compare

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

Christus Santa Rosa Medical Center

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450237
Location2827 Babcock RoadSan Antonio, TX 78229 · Bexar County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15213 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
96%145 patients4/55-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 2

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
2 suppliers34 claims34 services$13.63 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 suppliers45 claims45 services$58.47 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 20

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

CHELSIE DAHL
Nurse Anesthetist, Certified Registered
200 LOTHROP ST
PITTSBURGH, PA 15213
Allegheny County (412) 647-5909
OTHMAN MOHAMED-ASEM ABDUL-MALAK
Surgery (Vascular Surgery)
200 LOTHROP ST, F600 PRESBYTERIAN HOSPITAL
PITTSBURGH, PA 15213
Allegheny County (412) 647-2345
KAITLEN MORGAN
Nurse Practitioner (Critical Care Medicine)
200 LOTHROP ST, 613 SCAIFE HALL
PITTSBURGH, PA 15213
Allegheny County (412) 647-2345
UTPAL JHA M.D.
Internal Medicine (Critical Care Medicine)
200 LOTHROP ST
PITTSBURGH, PA 15213
Allegheny County (412) 530-6274
RACHEL IVY FRICK
Occupational Therapist
200 LOTHROP ST
PITTSBURGH, PA 15213
Allegheny County (412) 647-6017
ARTUR ZGUROV MD
Neurological Surgery
200 LOTHROP ST
PITTSBURGH, PA 15213
Allegheny County (412) 647-2345
KAREN KAIJIE XU MD
Student in an Organized Health Care Education/Training Program
200 LOTHROP ST
PITTSBURGH, PA 15213
Allegheny County (412) 647-2345
SAM ALLEN MICHELHAUGH MD
Student in an Organized Health Care Education/Training Program
200 LOTHROP ST
PITTSBURGH, PA 15213
Allegheny County (412) 770-4949

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 Carlos Nieto Fonseca's NPI number?

The NPI number for Carlos Nieto Fonseca is 1932367646. It was assigned to this individual provider in the NPPES registry on May 29, 2008.

Where is Carlos Nieto Fonseca located?

Carlos Nieto Fonseca practices at 200 Lothrop St, Pittsburgh, PA 15213. The listed phone number is (570) 259-7944.

What is Carlos Nieto Fonseca's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Carlos Nieto Fonseca enrolled in Medicare?

Yes. Carlos Nieto Fonseca 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 Carlos Nieto Fonseca accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and Molina Healthcare list Carlos Nieto Fonseca 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 Carlos Nieto Fonseca affiliated with any hospitals?

According to CMS data, Carlos Nieto Fonseca is affiliated with Christus Santa Rosa Medical Center.

When was this NPI record last updated?

The NPPES record for Carlos Nieto Fonseca was last updated on August 26, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.