DR. ERWIN DANILO SANCHEZ MD
NPI 1528012440
Pediatrics in Harlingen, TX
NPI Status: Active since May 22, 2006
Contact Information
321 S 21ST ST
HARLINGEN, TX
ZIP 78550
Phone: (956) 425-8761
Fax: (956) 425-9207
- Individual
- Male
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About ERWIN SANCHEZ
This page provides the complete NPI Profile along with additional information for Erwin Sanchez, a pediatrician established in Harlingen, Texas with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1528012440 assigned on May 2006. The practitioner's primary taxonomy code is 208000000X with license number L7157 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1528012440
- Provider Name
- DR. ERWIN DANILO SANCHEZ MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 321 S 21ST ST HARLINGEN, TX 78550
- Location Phone
- (956) 425-8761
- Location Fax
- (956) 425-9207
- Mailing Address
- 321 S 21ST ST HARLINGEN, TX 78550
- Mailing Phone
- (956) 425-8761
- Mailing Fax
- (956) 425-9207
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-22-2006
- Last Update Date
- 03-07-2023
- Code Navigator
A pediatrician like Erwin Sanchez is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, 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
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- L7157
- License State
- TX
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Standard - HMO
- UHC Gold Standard $0 Indiv Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Standard - HMO
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 |
|---|---|---|---|
| 30129643 | OTHER (01) | TX | DPS |
| L7157 | OTHER (01) | TX | STATE LICENSE |
Medicare Participation & PECOS Enrollment Status
Erwin Sanchez 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
Physician 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 78550 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.92
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $21.23
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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.
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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 | 5 | 2 | 8 | 0 | 1 | 2 | 4 | 4 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 4 | 8 | 0 | 1 | 4 | 4 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 4 + 8 + 0 + 1 + 4 + 4 + 8 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1528012440 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1649339656 | DR. STANLEY I FISCH MD Individual | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8761 |
| 1700945227 | FRY TOVAR INC Organization | Pharmacist | 321 S 21ST ST HARLINGEN, TX 78550 (956) 423-1200 |
| 1528105475 | DR. MARIBELLE GARZA MD Individual | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8762 |
| 1164569026 | DR. FRANCISCO R PAPILLA MD Individual | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8761 |
| 1023103058 | DR. ELEONOR IGNACIO CAJITA MD Individual | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8761 |
| 1033762539 | ALICIA GONZALEZ FNP-C Individual | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8761 |
| 1568801546 | DR. STEPHANIE RENEE HINOJOSA M.D. Individual | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8761 |
| 1124084058 | HARLINGEN PEDIATRICS ASSOCIATES Organization | Pediatrics | 321 S 21ST ST HARLINGEN, TX 78550 (956) 425-8762 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528012440, enumerated in the NPI registry as an "individual" on May 22, 2006
The provider is located at 321 S 21st St Harlingen, Tx 78550 and the phone number is (956) 425-8761
The provider's speciality is Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Aetna CVS Health, Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
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 $84.92 with an average copayment of $21.23 for new patient appointments. Established patients should expect a typical charge of $97.05 and an average copayment of 24.26. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on May 22, 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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