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DR. GERARD JOAQUIM CARVALHO M.D.
NPI 1992721054
Otolaryngology in Hemet, CA

Active since July 14, 2006PECOS EnrolledAccepts Medicare Assignment
0/100
CMS Quality Rating
118 N SANTA FE ST, STE B, HEMET, CA 92543(951) 925-8811(951) 925-8860 Get Directions Write a Review

NPPES record last updated: August 7, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Gerard Joaquim Carvalho M.d. NPPES

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

DR. GERARD JOAQUIM CARVALHO M.D. (NPI 1992721054) is an individual otolaryngology provider in Hemet, California, licensed in California (A69700) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (1998).

NPPES Registry Identity

NPI1992721054
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. GERARD JOAQUIM CARVALHOCredential: M.D.
Location Address118 N SANTA FE ST, STE BHemet, CA 92543-4441
Mailing Address118 N Santa Fe St, Ste BHemet, CA 92543-4441 · (951) 925-8811 · Fax (951) 925-8860
Phone(951) 925-8811
Fax(951) 925-8860
Sole ProprietorNo
Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 1998
Enumeration DateJuly 14, 2006
Last NPPES UpdateAugust 7, 2013
✔ NPI 1992721054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in CA · A69700
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
118 N SANTA FE ST, Hemet, CA 92543
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINH95390
Medicare ID-Type Unspecified00A697000

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. Gerard Joaquim Carvalho M.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 ID8426288788
PECOS Enrollment IDI20140306000250
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.

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.
778 services430 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
215 services208 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
207 services207 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
116 services96 patients
Exam of ear using a microscope 92504
An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.
47 services43 patients
Control of bleeding of nose using an endoscope 31238
This is a procedure where an endoscope, a thin tube with a light and camera, is used to view inside your nose. This allows the doctor to locate the source of the bleeding and control it, often by cauterization or packing the nose.
22 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92543 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
$136.04 typical visit price
range $59.60 – $179.42
Typical copayment $34.01 (range $14.90 – $44.85)
Most-billed visit code 99204
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
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.

0/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0

Reported Quality Measures

Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use
Percentage of patients aged 2 years and older with a diagnosis of AOE who were not prescribed systemic antimicrobial therapy
100%21 patients
Acute Otitis Externa (AOE): Topical Therapy
Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations
100%21 patients5/55-star benchmark: 100%
Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)
Percentage of patients aged 18 years and older with a diagnosis of acute bacterial sinusitis that were prescribed amoxicillin, with or without clavulanate, as a first line antibiotic at the time of diagnosis
100%21 patients5/55-star benchmark: 100%
Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%20 patients
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.
100%41 patients5/55-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%120 patients5/55-star benchmark: 100%
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
5%40 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
98%41 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.

Other Providers at the Same Location NPPES

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

GUILHERME R CARVALHO M.D. INC.
Internal Medicine
118 N SANTA FE ST, STE A
HEMET, CA 92543
Riverside County (951) 652-6891

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 Gerard Carvalho's NPI number?

The NPI number for Gerard Carvalho is 1992721054. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Where is Gerard Carvalho located?

Gerard Carvalho practices at 118 N Santa Fe St Ste B, Hemet, CA 92543. The listed phone number is (951) 925-8811.

What is Gerard Carvalho's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Gerard Carvalho enrolled in Medicare?

Yes. Gerard Carvalho 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 Gerard Carvalho was last updated on August 7, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.