DR. RICARDO JESUS REINA-SANABRIA MD
NPI 1992782551
Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery in San Juan, PR
NPI Status: Active since December 27, 2005
Contact Information
576 AVE CESAR GONZALEZ
SUITE 506 DORAL BANK CENTER
SAN JUAN, PR
ZIP 00917
Phone: (787) 772-1007
Fax: (787) 772-1009
- Individual
- Male
- Years of Experience 30
- Orthopaedic Surgery
- Adult Reconstructive Orthopaedic Surgery
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About RICARDO REINA-SANABRIA
This page provides the complete NPI Profile along with additional information for Ricardo Reina-sanabria, a provider established in San Juan, Puerto Rico with a medical specialization in Orthopaedic Surgery, focusing in adult reconstructive orthopaedic surgery and more than 30 years of experience. The healthcare provider is registered in the NPI registry with number 1992782551 assigned on December 2005. The practitioner's primary taxonomy code is 207XS0114X with license number 13805 (PR). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1992782551
- Provider Name
- DR. RICARDO JESUS REINA-SANABRIA MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 576 AVE CESAR GONZALEZ SUITE 506 DORAL BANK CENTER SAN JUAN, PR 00917
- Location Phone
- (787) 772-1007
- Location Fax
- (787) 772-1009
- Mailing Address
- 100 GRAND BLVD PASEOS SUITE 112 MSC 313 SAN JUAN, PR 00926
- Mailing Phone
- (787) 287-4938
- Medical School Name
- OTHER
- Graduation Year
- 1996
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-27-2005
- Last Update Date
- 03-15-2024
- Code Navigator
Location Map
Secondary Locations
- Torre Medica Auxilio Mutuo 735 Ave Ponce de Leon Suite 519
San Juan, PR 00917
(787) 772-1007
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
Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery
- Taxonomy Code
- 207XS0114X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 13805
- License State
- PR
- Taxonomy Description
- Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
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 | Identifier Issuer |
|---|---|---|---|
| 1989 | OTHER (01) | PR | PREFERRED MEDICARE CHOICE |
| 2002639 | OTHER (01) | PR | ACAA |
| 9170108 | OTHER (01) | PR | HUMANA HEALTH |
| 062032 | OTHER (01) | PR | CRUZ AZUL |
| 13713805 | OTHER (01) | PR | GLOBAL HEALTH |
| 20980RE | OTHER (01) | PR | SSS |
| 9170108 | OTHER (01) | PR | HUMANA INSURANCE |
Medicare Participation & PECOS Enrollment Status
Ricardo Reina-sanabria 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.
Ricardo Reina-sanabria 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: 3476451980
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: I20031222000497
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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Walker, folding (pickup), adjustable or fixed height (HCPCS:E0135)
3 DME suppliers used 41 Medicare Claims 41 Services Paid
DME-Other DME (DE000N)
Commode chair, mobile or stationary, with fixed arms (HCPCS:E0163)
3 DME suppliers used 42 Medicare Claims 42 Services Paid
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.
Aspiration and/or injection of fluid from large joint
Established patient office or other outpatient visit, 20-29 minutes
Hip replacement
Knee replacement
Lower limb (leg) arthroscopy (minimally invasive joint repair)
New patient office or other outpatient visit, 30-44 minutes
Replacement of knee joint, both sides of knee
Replacement of thigh bone and hip joint with prosthesis
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
This service was performed 15 times for 11 patientsThis 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.
This service was performed 262 times for 198 patientsA hip replacement is a surgical procedure where a worn-out or damaged hip joint is replaced with an artificial one. This procedure can greatly reduce pain and improve mobility. It's often recommended when other treatments like physical therapy or medications fail to alleviate symptoms.
This service was performed for 74 patientsA knee replacement is a surgical procedure where a damaged or diseased knee joint is replaced with an artificial one. This can relieve pain and improve mobility. The procedure involves removing damaged parts of the knee and inserting a prosthetic joint. Recovery may take several weeks.
This service was performed for 377 patientsLower limb arthroscopy is a minimally invasive procedure that allows doctors to examine and repair issues in your leg joints. It involves making small incisions through which a tiny camera and instruments are inserted. This technique can help diagnose and treat various joint problems with less pain and quicker recovery time.
This service was performed for 1-10 patientsThis 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.
This service was performed 57 times for 57 patientsA bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
This service was performed 62 times for 61 patientsThis procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.
This service was performed 17 times for 17 patientsQuality 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 |
|---|---|---|
| Advance Care Planning | Yes | N/A |
| Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning. | ||
| e-Prescribing | 71% | 108 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Implementation of fall screening and assessment programs | Yes | N/A |
| Implementation of fall screening and assessment programs to identify patients at risk for falls and address modifiable risk factors (e.g., Clinical decision support/prompts in the electronic health record that help manage the use of medications, such as benzodiazepines, that increase fall risk). | ||
| Patient-Specific Education | 30% | 2009 |
| 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. | ||
| Provide Patient Access | 100% | 2009 |
| 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 | 54% | 2009 |
| 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. | ||
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. Ricardo Reina-sanabria is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| PRESBYTERIAN COMMUNITY HOSP | 1451 ASHFORD AVENUE SAN JUAN, PR 00907 | (787) 721-2160 | Acute Care Hospitals | |
| AUXILIO MUTUO HOSPITAL | PONCE DE LEON AVENUE 735 STOP 37 1/2 SAN JUAN, PR 00918 | (787) 758-2000 | Acute Care Hospitals |
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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 1992782551, we treat the final digit (1) 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 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 69 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992782551, enumerated as an "individual" on December 27, 2005.
The provider is located at 576 AVE CESAR GONZALEZ SUITE 506 DORAL BANK CENTER SAN JUAN, PR 00917 and the phone number is (787) 772-1007.
Orthopaedic Surgery with taxonomy code 207XS0114X and a focus in Adult Reconstructive Orthopaedic Surgery.
The provider might be accepting Accepts: Medicare, Medicaid and Humana. Please consult your insurance carrier or call the provider to verify.
Ricardo Reina-sanabria is affiliated with: PRESBYTERIAN COMMUNITY HOSP and AUXILIO MUTUO HOSPITAL.
