SANJA KUPESIC-PLAVSIC M.D.
NPI 1609900232
Obstetrics & Gynecology in El Paso, TX
NPI Status: Active since March 15, 2007
- Individual
- Female
- Obstetrics & Gynecology
- Accepts Insurance
- PECOS Enrolled
About SANJA KUPESIC-PLAVSIC
This page provides the complete NPI Profile along with additional information for Sanja Kupesic-plavsic, a women's health care provider established in El Paso, Texas with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1609900232 assigned on March 2007. The practitioner's primary taxonomy code is 207V00000X with license number P1192 (TX). The provider is registered as an individual and her NPI record was last updated 2 years ago.
- NPI
- 1609900232
- Provider Name
- SANJA KUPESIC-PLAVSIC M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4801 ALBERTA AVE EL PASO, TX 79905
- Location Phone
- (915) 215-5000
- Mailing Address
- 5130 GATEWAY BLVD E # 51015 EL PASO, TX 79905
- Mailing Phone
- (915) 215-4480
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-15-2007
- Last Update Date
- 11-08-2023
- Code Navigator
Women's health care providers like Sanja Kupesic-plavsic treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, 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
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- P1192
- License State
- TX
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- 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
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- Connect Bronze 5500 Indiv Med Deductible - HMO
- Connect Bronze 6000 Indiv Med Deductible - HMO
- Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - HMO
- Connect Bronze 8500 Indiv Med Deductible - HMO
- Connect Bronze CMS Standard - HMO
- Connect Bronze DFW 6500 Indiv Med Deductible Enhanced Diabetes Care - HMO
- Connect Gold 1000 Indiv Med Deductible - HMO
- Connect Gold 2500 Indiv Med Deductible Enhanced Diabetes Care - HMO
- Connect Gold 3250 Indiv Med Deductible - HMO
- Connect Gold 3500 Indiv Med Deductible - HMO
- Connect Gold CMS Standard - HMO
- Connect Silver 3000 Indiv Med Deductible - HMO
- Connect Silver 4000 Indiv Med Deductible - HMO
- Connect Silver CMS Standard - HMO
- Imperial Preferred Bronze - HMO
- Imperial Preferred Gold - HMO
- Imperial Preferred Gold Zero - HMO
- Imperial Preferred Silver - HMO
- Imperial Standard Bronze - HMO
- Imperial Standard Gold - HMO
- Imperial Standard Silver - 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 |
|---|---|---|---|
| P1192 | OTHER (01) | TX | MEDICAL LICENSE |
Medicare Participation & PECOS Enrollment Status
Sanja Kupesic-plavsic 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 79905 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- 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 99213
- Average Established Patient Price $68.55
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $17.13
- 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 | 6 | 0 | 9 | 9 | 0 | 0 | 2 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 0 | 9 | 18 | 0 | 0 | 2 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 0 + 9 + 1 + 8 + 0 + 0 + 2 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1609900232 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1659331569 | DR. RAYMOND J. BAGG M.D. Individual | Orthopaedic Surgery | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-9795 |
| 1326155813 | JEFFREY D. SCHUSTER M.D. Individual | Pediatrics (Pediatric Cardiology) | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6817 |
| 1104933522 | MANUEL SCHYDLOWER M.D. Individual | Pediatrics | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6817 |
| 1003996851 | ELVIA MARTINEZ LSW/CPW Individual | Case Manager/Care Coordinator | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6990 |
| 1033291810 | INES MARIA ANCHONDO DIETITIAN Individual | Dietitian, Registered | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-9795 |
| 1225111479 | GRACIELA CAMACHO LSW/CPW Individual | Case Manager/Care Coordinator | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6763 |
| 1255492898 | MARIA MAGDALENA BARRON NPC Individual | Registered Nurse (Neonatal, Low-Risk) | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6817 |
| 1023204799 | TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER AT EL PASO Organization | General Acute Care Hospital | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-7300 |
| 1760678353 | TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER Organization | General Acute Care Hospital | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6520 |
| 1114113818 | DR. NAMRATA MAHENDRA PATEL M.D. Individual | Emergency Medicine | 4801 ALBERTA AVE EMERGENCY MEDICINE EL PASO, TX 79905 (915) 545-6739 |
| 1932495256 | DR. ANGELICA AURORA NUNEZ M.D. Individual | Internal Medicine | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-0982 |
| 1215215223 | MRS. STACY SHELTON BROADDUS NP, CNM Individual | Advanced Practice Midwife | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6490 |
| 1902170194 | ELISA CHRISTINE STUMP NNP Individual | Nurse Practitioner (Neonatal) | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6755 |
| 1568474880 | OSCAR BLANC M.D. Individual | Pediatrics | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6817 |
| 1558374868 | JOSE MANUEL DE LA ROSA M.D. Individual | Pediatrics | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6817 |
| 1972610319 | DR. PRATIBHA K. SHIRSAT M.D Individual | Pediatrics | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-9681 |
| 1982704821 | MARY E LACAZE MD Individual | Pediatrics | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6816 |
| 1568508638 | DR. INDU PATHAK M.D. Individual | Pediatrics | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6817 |
| 1801025416 | NICHOLE R ANDREWS M.D. Individual | Emergency Medicine | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-7333 |
| 1316033889 | MICHELE FOLLEN M.D., PHD Individual | Obstetrics & Gynecology (Gynecologic Oncology) | 4801 ALBERTA AVE EL PASO, TX 79905 (915) 545-6611 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1609900232, enumerated in the NPI registry as an "individual" on March 15, 2007
The provider is located at 4801 Alberta Ave El Paso, Tx 79905 and the phone number is (915) 215-5000
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Cigna. 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 $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $68.55 and an average copayment of 17.13. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on March 15, 2007. 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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