DR. LUIS JAVIER VICTORES MD
NPI 1952330508
Internal Medicine - Gastroenterology in Hialeah, FL

NPI Status: Active since July 03, 2006

Contact Information

315 W 49TH ST
HIALEAH, FL
ZIP 33012
Phone: (305) 820-4426
Fax: (305) 820-4436

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 40
Internal Medicine
Gastroenterology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting
CLIA Number: 10D0976999
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 08-16-2026

About LUIS VICTORES

This page provides the complete NPI Profile along with additional information for Luis Victores, an internist established in Hialeah, Florida with a medical specialization in Internal Medicine, focusing in gastroenterology and more than 40 years of experience. The healthcare provider is registered in the NPI registry with number 1952330508 assigned on July 2006. The practitioner's primary taxonomy code is 207RG0100X with license number ME79770 (FL). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI: 1952330508
Provider Name: DR. LUIS JAVIER VICTORES MD
Gender: Male
Entity Type: Individual
Location Address: 315 W 49TH ST HIALEAH, FL 33012
Location Phone: (305) 820-4426
Location Fax: (305) 820-4436
Mailing Address: 315 W 49TH ST HIALEAH, FL 33012
Mailing Phone: (305) 820-4426
Mailing Fax: (305) 820-4436
Medical School Name: OTHER
Graduation Year: 1986
Is Sole Proprietor?: No
Enumeration Date: 07-03-2006
Last Update Date: 07-08-2007
Code Navigator

An internist like Luis Victores is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

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: Internal Medicine Gastroenterology
Taxonomy Code: 207RG0100X
Type: Allopathic & Osteopathic Physicians
License No.: ME79770
License State: FL
Taxonomy Description: An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Molina Healthcare

Molina Bronze Enhanced 3500 - HMO
Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
Molina Bronze Premier with $0 Medical Deductible - HMO
Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision - HMO
Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision - HMO
Molina Bronze Standard - HMO
Molina Gold Core 1640 - HMO
Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
Molina Gold Core 1640 Plus with Adult Vision - HMO
Molina Gold Enhanced 895 - HMO
Molina Gold Enhanced 895 Plus with Adult Dental and Vision - HMO
Molina Gold Enhanced 895 Plus with Adult Vision - HMO
Molina Gold Standard - HMO
Molina Silver Access - HMO
Molina Silver Access Plus with Adult Dental and Vision - HMO
Molina Silver Access Plus with Adult Vision - HMO
Molina Silver Core - HMO
Molina Silver Core Plus with Adult Dental and Vision - HMO
Molina Silver Core Plus with Adult Vision - HMO

Oscar Health Maintenance Organization of Florida

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

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
H24208	MEDICARE UPIN (02)	FL
259075100	MEDICAID (05)	FL
E4543	MEDICARE ID-TYPE UNSPECIFIED (04)	FL

Medicare Participation & PECOS Enrollment Status

Luis Victores is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Luis Victores 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
PECOS PAC ID: 6406932813
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20080326000314
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope
Diagnostic exam of large bowel using a flexible endoscope
Established patient office or other outpatient visit, 30-39 minutes
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
New patient office or other outpatient visit, 45-59 minutes
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $35.39 for a new patient copayment and $26.79 for an established patient copayment.

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 33012 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $141.56
Minimum New Patient Price $60.92
Maximum New Patient Price $187.05

Average New Patient Copayment $35.39
Minimum New Patient Copayment $15.23
Maximum New Patient Copayment $46.76

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $107.17
Minimum Established Patient Price $18.99
Maximum Established Patient Price $150.24

Average Established Patient Copayment $26.79
Minimum Established Patient Copayment $4.74
Maximum Established Patient Copayment $37.56

* 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.

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
Colorectal Cancer Screening	52%	183
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes screening	Yes	N/A
Diabetes screening for people with schizophrenia or bipolar disease who are using antipsychotic medication.
Documentation of Current Medications in the Medical Record	100%	361
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Electronic Health Record Enhancements for BH data capture	Yes	N/A
Enhancements to an electronic health record to capture additional data on behavioral health (BH) populations and use that data for additional decision-making purposes (e.g., capture of additional BH data results in additional depression screening for at-risk patient not previously identified).
Engage Patients and Families to Guide Improvement in the System of Care	Yes	N/A
Engage patients and families to guide improvement in the system of care by leveraging digital tools for ongoing guidance and assessments outside the encounter, including the collection and use of patient data for return-to-work and patient quality of life improvement. Platforms and devices that collect patient-generated health data (PGHD) must do so with an active feedback loop, either providing PGHD in real or near-real time to the care team, or generating clinically endorsed real or near-real time automated feedback to the patient, including patient reported outcomes (PROs). Examples include patient engagement and outcomes tracking platforms, cellular or web-enabled bi-directional systems, and other devices that transmit clinically valid objective and subjective data back to care teams. Because many consumer-grade devices capture PGHD (for example, wellness devices), platforms or devices eligible for this improvement activity must be, at a minimum, endorsed and offered clinically by care teams to patients to automatically send ongoing guidance (one way). Platforms and devices that additionally collect PGHD must do so with an active feedback loop, either providing PGHD in real or near-real time to the care team, or generating clinically endorsed real or near-real time automated feedback to the patient (e.g. automated patient-facing instructions based on glucometer readings). Therefore, unlike passive platforms or devices that may collect but do not transmit PGHD in real or near-real time to clinical care teams, active devices and platforms can inform the patient or the clinical care team in a timely manner of important parameters regarding a patient’s status, adherence, comprehension, and indicators of clinical concern.
Engagement of community for health status improvement	Yes	N/A
Take steps to improve health status of communities, such as collaborating with key partners and stakeholders to implement evidenced-based practices to improve a specific chronic condition. Refer to the local Quality Improvement Organization (QIO) for additional steps to take for improving health status of communities as there are many steps to select from for satisfying this activity. QIOs work under the direction of CMS to assist MIPS eligible clinicians and groups with quality improvement, and review quality concerns for the protection of beneficiaries and the Medicare Trust Fund.
Engagement of New Medicaid Patients and Follow-up	Yes	N/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
Engagement of Patients, Family, and Caregivers in Developing a Plan of Care	Yes	N/A
Engage patients, family, and caregivers in developing a plan of care and prioritizing their goals for action, documented in the electronic health record (EHR) technology.
Enhancements/regular updates to practice websites/tools that also include considerations for patients with cognitive disabilities	Yes	N/A
Enhancements and ongoing regular updates and use of websites/tools that include consideration for compliance with section 508 of the Rehabilitation Act of 1973 or for improved design for patients with cognitive disabilities. Refer to the CMS website on Section 508 of the Rehabilitation Act https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/Section508/index.html?redirect=/InfoTechGenInfo/07_Section508.asp that requires that institutions receiving federal funds solicit, procure, maintain and use all electronic and information technology (EIT) so that equal or alternate/comparable access is given to members of the public with and without disabilities. For example, this includes designing a patient portal or website that is compliant with section 508 of the Rehabilitation Act of 1973
Evidenced-based techniques to promote self-management into usual care	Yes	N/A
Incorporate evidence-based techniques to promote self-management into usual care, using techniques such as goal setting with structured follow-up, Teach Back, action planning or motivational interviewing.
Falls: Screening for Future Fall Risk	82%	164
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Glycemic management services	Yes	N/A
For outpatient Medicare beneficiaries with diabetes and who are prescribed antidiabetic agents (e.g., insulin, sulfonylureas), MIPS eligible clinicians and groups must attest to having: For the first performance year, at least 60 percent of medical records with documentation of an individualized glycemic treatment goal that: a) Takes into account patient-specific factors, including, at least 1) age, 2) comorbidities, and 3) risk for hypoglycemia, and b) Is reassessed at least annually. The performance threshold will increase to 75 percent for the second performance year and onward. Clinician would attest that, 60 percent for first year, or 75 percent for the second year, of their medical records that document individualized glycemic treatment represent patients who are being treated for at least 90 days during the performance period.
Medication Reconciliation	100%	361
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.
Patient-Specific Education	100%	286
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.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	54%	286
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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Provide Patient Access	2%	286
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 certain information.
Secure Messaging	0%	286
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of High-Risk Medications in the Elderly	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	164
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. 2) Percentage of patients who were ordered at least two of the same high-risk medication

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Luis Victores is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS	1475 W 49TH ST HIALEAH, FL 33012	(305) 558-2500	Acute Care Hospitals

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 10D0976999
Facility Type: Physician Office
Certificate Effective Date: August 17, 2024
Certificate Expiration Date: August 16, 2026
Laboratory Director: LUIS J. VICTORES MD
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Luis Victores to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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 1952330508, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

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.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 10 → 1 + 0

Pos 4

Unchanged

Pos 5

Doubled → 6

Pos 6

Unchanged

Pos 7

Doubled → 0

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 3 → 6 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 0 + 2 + 6 + 3 + 0 + 5 + 0 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8

This NPI is valid

The calculated check digit is 8, which matches the last digit of 1952330508.

Other Providers at the Same Location

The following 2 providers are registered at the same or a nearby location.

SONIA M JIMENEZ -VICTORES ENDOCRINOLOGY LLC

Internal Medicine (Endocrinology, Diabetes & Metabolism)

315 W 49TH ST, SUITE A
HIALEAH, FL 33012

Miami-Dade County (305) 820-4426

DR. SONIA M JIMENEZ-VICTORES M.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)

315 W 49TH ST, SUITE A
HIALEAH, FL 33012

Miami-Dade County (305) 820-4426

About LUIS VICTORES

Location Map

Specialty - Primary Taxonomy

Internal Medicine Gastroenterology

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 6406932813

PECOS Enrollment ID: I20080326000314

Accepts Medicare Assignment? 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

Areas of Expertise

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

Diagnostic exam of large bowel using a flexible endoscope

Established patient office or other outpatient visit, 30-39 minutes

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes

New patient office or other outpatient visit, 45-59 minutes

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Quality Reporting

Find Provider Hospital Affiliations - Privileges

CLIA Information

Reviews for DR. LUIS JAVIER VICTORES MD

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

Step 3: Find the amount needed to reach the next multiple of 10

Other Providers at the Same Location

Frequently Asked Questions