ROSALIZ M PORTELA MD
NPI 1235159005
Ophthalmology in San Juan, PR
NPI Status: Active since July 21, 2006
Contact Information
AVE JESUS T PINERO
#1250
SAN JUAN, PR
ZIP 00918
Phone: (787) 781-2565
Fax: (787) 782-9524
- Individual
- Female
- Ophthalmology
- PECOS Enrolled
- Medicare Quality Reporting
About ROSALIZ PORTELA
This page provides the complete NPI Profile along with additional information for Rosaliz Portela, a provider established in San Juan, Puerto Rico with a medical specialization in Ophthalmology. The healthcare provider is registered in the NPI registry with number 1235159005 assigned on July 2006. The practitioner's primary taxonomy code is 207W00000X with license number 17093 (PR). The provider is registered as an individual and her NPI record was last updated 15 years ago.
- NPI
- 1235159005
- Provider Name
- ROSALIZ M PORTELA MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- AVE JESUS T PINERO #1250 SAN JUAN, PR 00918
- Location Phone
- (787) 781-2565
- Location Fax
- (787) 782-9524
- Mailing Address
- PO BOX 10431 SAN JUAN, PR 00922
- Mailing Phone
- (787) 781-2565
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-21-2006
- Last Update Date
- 08-06-2010
- Code Navigator
Ophthalmologists like Rosaliz Portela specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.
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
Ophthalmology
- Taxonomy Code
- 207W00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 17093
- License State
- PR
- Taxonomy Description
- An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | 044112 (CT) |
Medicare Participation & PECOS Enrollment Status
Rosaliz Portela 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
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.
2d ultrasound scan of eye tissue and structures
Established patient complete exam of visual system
Established patient problem focused exam of visual system
Exam of retinal blood vessels using a special camera after injection of a dye
Extended exam of the back part of the eye with retinal drawing
Imaging of retina
Microfluid analysis of tears
Photography of the retina
A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.
This service was performed 118 times for 55 patientsAn established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
This service was performed 39 times for 33 patientsThis is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
This service was performed 70 times for 46 patientsThis procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.
This service was performed 14 times for 14 patientsThis procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.
This service was performed 109 times for 74 patientsImaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
This service was performed 136 times for 80 patientsMicrofluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.
This service was performed 80 times for 40 patientsPhotography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
This service was performed 42 times for 38 patientsPhysician Visit Costs
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 00918 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $130.65
- Minimum New Patient Price $56.86
- Maximum New Patient Price $172.44
- Average New Patient Copayment $32.66
- Minimum New Patient Copayment $14.21
- Maximum New Patient Copayment $43.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.88
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.44
- Average Established Patient Copayment $17.72
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.11
* 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 |
---|---|---|
Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 8% | 327 |
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the Age-Related Eye Disease Study (AREDS) formulation for preventing progression of AMD | ||
Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 98% | 327 |
Percentage of patients aged 50 years and older with a diagnosis of age-related macular degeneration (AMD) who had a dilated macular examination performed which included documentation of the presence or absence of macular thickening or geographic atrophy or hemorrhage AND the level of macular degeneration severity during one or more office visits within 12 months | ||
Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
Diabetes: Eye Exam | 95% | 805 |
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period | ||
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy | 99% | 728 |
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months | ||
Documentation of Current Medications in the Medical Record | 100% | 3046 |
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 | ||
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. | ||
Medication Reconciliation | 64% | 47 |
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 | 48% | 905 |
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. | ||
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 77% | 202 |
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months | ||
Provide Patient Access | 0% | 1417 |
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. | ||
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. | ||
Tobacco use | Yes | N/A |
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence. | ||
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. | 1083 |
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 |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 2 | 3 | 5 | 1 | 5 | 9 | 0 | 0 | 5 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 2 | 6 | 5 | 2 | 5 | 18 | 0 | 0 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 2 + 6 + 5 + 2 + 5 + 1 + 8 + 0 + 0 + 24 = 55 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 55 = 5 | 5 |
The NPI number 1235159005 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235159005, enumerated in the NPI registry as an "individual" on July 21, 2006
The provider is located at Ave Jesus T Pinero #1250 San Juan, Pr 00918 and the phone number is (787) 781-2565
The provider's speciality is Ophthalmology with taxonomy code 207W00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $130.65 with an average copayment of $32.66 for new patient appointments. Established patients should expect a typical charge of $70.88 and an average copayment of 17.72. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: 2d ultrasound scan of eye tissue and structures, Established patient complete exam of visual system, Established patient problem focused exam of visual system, Exam of retinal blood vessels using a special camera after injection of a dye, Extended exam of the back part of the eye with retinal drawing, Imaging of retina, Microfluid analysis of tears and Photography of the retina.
This NPI record was last updated on July 21, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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