DR. MARSHA RAE GRIFFIN M.D.
NPI 1891714309
Pediatrics in Edinburg, TX
NPI Status: Active since July 18, 2006
Contact Information
4150 CROSSPOINT BLVD
EDINBURG, TX
ZIP 78539
Phone: (956) 381-5817
Fax: (956) 381-5397
- Individual
- Female
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About MARSHA GRIFFIN
This page provides the complete NPI Profile along with additional information for Marsha Griffin, a pediatrician established in Edinburg, Texas with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1891714309 assigned on July 2006. The practitioner's primary taxonomy code is 208000000X with license number M3565 (TX). The provider is registered as an individual and her NPI record was last updated 7 years ago.
- NPI
- 1891714309
- Provider Name
- DR. MARSHA RAE GRIFFIN M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4150 CROSSPOINT BLVD EDINBURG, TX 78539
- Location Phone
- (956) 381-5817
- Location Fax
- (956) 381-5397
- Mailing Address
- 2102 TREASURE HILLS BLVD # 3.14406 HARLINGEN, TX 78550
- Mailing Phone
- (956) 296-1437
- Mailing Fax
- (956) 381-5397
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-18-2006
- Last Update Date
- 08-17-2018
- Code Navigator
A pediatrician like Marsha Griffin 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
Secondary Locations
- 2102 Treasure Hills Blvd # 3.14405
Harlingen, TX 78550
(956) 296-1437
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.
- M3565
- 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:
- 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
- MyBlue Health Bronze? 402 - 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.
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 |
|---|---|---|---|
| H08GH00801 | OTHER (01) | TX | BCBS |
| M3565 | OTHER (01) | TX | MEDICAL BOARD LICENSE # |
| 1829814-04 | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
Marsha Griffin 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 78539 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.
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 |
|---|---|---|
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| 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. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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 | 8 | 9 | 1 | 7 | 1 | 4 | 3 | 0 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 18 | 1 | 14 | 1 | 8 | 3 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 8 + 1 + 1 + 4 + 1 + 8 + 3 + 0 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1891714309 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1669636304 | DR. MICHELLE A ZEAGER D.O., M.P.H. Individual | Pediatrics | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 381-5817 |
| 1881753671 | DR. HUMBERTO ARTURO HIDALGO MD Individual | Pediatrics (Pediatric Pulmonology) | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 381-5817 |
| 1346225190 | DR. SCOTT JAY SPEAR M.D. Individual | Pediatrics (Adolescent Medicine) | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
| 1093769184 | MRS. VANESSA SANCHEZ P.N.P. Individual | Nurse Practitioner (Pediatrics) | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
| 1619385408 | ANNA MARQUIS RN, MSN, FNP-BC Individual | Clinical Nurse Specialist (Family Health) | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
| 1003876798 | DR. JEREMY L. GIBSON M.D. Individual | Pediatrics | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
| 1326373598 | DR. LORI MICHELLE BERRY M.D. Individual | Pediatrics | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
| 1457326423 | DR. WAYNE BURLESON WILSON MD Individual | Obstetrics & Gynecology | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-3041 |
| 1962647172 | CYNTHIA A. FUENTES NP Individual | Nurse Practitioner | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-3041 |
| 1003332438 | ANGELA MARIA TANGUMA NP Individual | Nurse Practitioner | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 381-5817 |
| 1629323118 | DR. TARA PHILLIPP VIERRA M.D. Individual | Pediatrics | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
| 1346504875 | DR. ALBERTO ALLEGRE ALONSO M.D. Individual | Pediatrics (Developmental - Behavioral Pediatrics) | 4150 CROSSPOINT BLVD EDINBURG, TX 78539 (956) 296-1960 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1891714309, enumerated in the NPI registry as an "individual" on July 18, 2006
The provider is located at 4150 Crosspoint Blvd Edinburg, Tx 78539 and the phone number is (956) 381-5817
The provider's speciality is Pediatrics with taxonomy code 208000000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Blue Cross. 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 July 18, 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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