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DR. OSCAR F HERRERA M.D.
NPI 1962475111
Internal Medicine - Infectious Disease in Miami, FL

Active since February 08, 2006PECOS Enrolled
58.27/100
CMS Quality Rating
3901 NW 7TH ST., MIAMI, FL 33126(305) 854-1133(305) 514-0076 Get Directions Write a Review

NPPES record last updated: February 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Oscar F Herrera M.d. NPPES

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

DR. OSCAR F HERRERA M.D. (NPI 1962475111) is an individual infectious disease provider in Miami, Florida, licensed in Florida (ME90565) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Hca Florida Mercy Hospital, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1962475111
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. OSCAR F HERRERACredential: M.D.
Location Address3901 NW 7TH ST.Miami, FL 33126-5504
Mailing Address1825 Ponce De Leon Blvd., Suite 443Coral Gables, FL 33134-4418 · (305) 854-1133 · Fax (305) 514-0076
Phone(305) 854-1133
Fax(305) 514-0076
Sole ProprietorYes
Medical School CMSOtherGraduated 1997
Enumeration DateFebruary 8, 2006
Last NPPES UpdateFebruary 8, 2023
NPPES CertifiedFebruary 8, 2023
✔ NPI 1962475111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in FL · ME90565
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
Also ListedSpecialistTaxonomy 174400000X · License ME0090565 (FL)
3901 NW 7TH ST., Miami, FL 33126
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Other Names 1

Other Name (5)Oscar F Herrera Morillo

Other Identifiers 1

Medicaid105241000FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next 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 (PECOS)

Dr. Oscar F Herrera M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5496789836
PECOS Enrollment IDI20050924000039
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 6

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 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.
3,820 services529 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
659 services509 patients
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.
302 services65 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
94 services88 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
46 services36 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.
40 services26 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Mercy Hospital

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100167
Location3663 S Miami AveMiami, FL 33133 · Miami-Dade County
Emergency services Birthing friendly

Steward Coral Gables Hospital

Acute Care Hospitals · Coral Gables, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100183
Location3100 Douglas RdCoral Gables, FL 33134 · Miami-Dade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33126 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

58.27/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality76.82
Improvement Activities0
Cost58.48

Reported Quality Measures

Documentation of Current Medications in the Medical Record
86%189 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
79%180 patients4/55-star benchmark: 98%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 87% · 75 patients
Patients screened: 91% · 75 patients
8%75 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

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

OSCAR HERRERA MD PA
Internal Medicine (Infectious Disease)
3901 NW 7TH ST.
MIAMI, FL 33126
Miami-Dade County (305) 854-1133

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 Oscar Herrera's NPI number?

The NPI number for Oscar Herrera is 1962475111. It was assigned to this individual provider in the NPPES registry on February 8, 2006. The provider is also known as Oscar F Herrera Morillo.

Where is Oscar Herrera located?

Oscar Herrera practices at 3901 NW 7th St., Miami, FL 33126. The listed phone number is (305) 854-1133.

What is Oscar Herrera's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Oscar Herrera enrolled in Medicare?

Yes. Oscar Herrera is registered in the Medicare PECOS enrollment system.

What insurance does Oscar Herrera accept?

Health plans from Ambetter Health, Ambetter of Alabama, AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Oscar Herrera 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 Oscar Herrera affiliated with any hospitals?

According to CMS data, Oscar Herrera is affiliated with Hca Florida Mercy Hospital and Steward Coral Gables Hospital.

When was this NPI record last updated?

The NPPES record for Oscar Herrera was last updated on February 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.