DR. MARIO JAVIER PINEDA M.D./PH.D.
NPI 1942497359
Obstetrics & Gynecology - Gynecologic Oncology in Chandler, AZ

Q: What is Mario Pineda's NPI number?

The NPI number for Mario Pineda is 1942497359. It was assigned to this individual provider in the NPPES registry on September 29, 2007.

Q: What is Mario Pineda's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

Q: When was this NPI record last updated?

The NPPES record for Mario Pineda was last updated on November 14, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 29, 2007PECOS EnrolledAccepts Medicare Assignment

93.61/100

CMS Quality Rating

685 S DOBSON RD, CHANDLER, AZ 85224(480) 821-2838 Get Directions Write a Review

NPPES record last updated: November 14, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 14, 2022, Nov 30, 2018, Mar 17, 2018 and 4 more (7 updates tracked since 2017).

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About Dr. Mario Javier Pineda M.d./ph.d. NPPES

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

DR. MARIO JAVIER PINEDA M.D./PH.D. (NPI 1942497359) is an individual gynecologic oncology provider in Chandler, Arizona, licensed in Arizona (54173) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Washington School Of Medicine (2007).

NPPES Registry Identity

NPI1942497359

Entity TypeIndividualMale

Primary Taxonomy207VX0201X

Provider Legal NameDR. MARIO JAVIER PINEDACredential: M.D./PH.D.

Location Address685 S DOBSON RDChandler, AZ 85224-5665

Mailing AddressPo Box 6423Chandler, AZ 85246-6423 · (480) 821-2838 · Fax (480) 821-9444

Phone(480) 821-2838

Sole ProprietorNo

Medical School CMSUniversity Of Washington School Of MedicineGraduated 2007

Enumeration DateSeptember 29, 2007

Last NPPES UpdateNovember 14, 20227 updates tracked since enumeration

NPPES CertifiedNovember 14, 2022

✔ NPI 1942497359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207VX0201X

License✔ Licensed in AZ · 54173

Definition

An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

685 S DOBSON RD, Chandler, AZ 85224

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Other Identifiers 1

Medicaid259195AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and more.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. Mario Javier Pineda M.d./ph.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 ID2062638810

PECOS Enrollment IDI20170731000719

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 7

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.

206 services72 patients

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.

128 services93 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

64 services13 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

55 services27 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.

31 services31 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.

16 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85224 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

$168.60 typical visit price

range $55.44 – $168.60

Typical copayment $42.15 (range $13.86 – $42.15)

Most-billed visit code 99205

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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.

93.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Quality

97.66

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

65%189 patients3/55-star benchmark: 92%

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…

97%141 patients4/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

51%202 patients3/55-star benchmark: 85%

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.

90%980 patients4/55-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…

54%243 patients3/55-star benchmark: 98%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

95%329 patients4/55-star benchmark: 100%

Pain Assessment and Follow-Up

Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present

87%756 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

5%398 patients1/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

77%141 patients4/55-star benchmark: 90%

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

47%149 patients3/55-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 screenedForUse: 100% · 219 patients

Patients tobacco: 97% · 219 patients

75%24 patients4/55-star benchmark: 98%

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…

17%398 patients1/55-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.

Other Providers at the Same Location NPPES 11

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

DAVID J. HETZEL M.D.

Obstetrics & Gynecology (Gynecologic Oncology)