Active NPI 1386661155 Individual Practitioner Male Practitioner

Dr. Marcos A Ugarte , MD

Surgery • Hanover, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Marcos Ugarte, MD is a certified Surgery practicing in Hanover, PA. With approximately 38 years of clinical experience since graduating from University Of Maryland School Of Medicine in 1988, Dr. Ugarte delivers high-quality medical care to the local community at 401 ALLEGHENY AVE.

Dr. Ugarte is affiliated with Pinnacle Health Medical Services and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

401 Allegheny Ave

Hanover, PA 173311949

Telephone 7176302844

Fax 7176302834

Medicare Profile & Education

Medical School

University Of Maryland School Of Medicine

Graduation Year

1988

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Hanover, PA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

38 Yrs +2.3 yrs vs City Avg

City Avg: 35.7 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

4 Specialists

Practicing in Hanover, PA (1976 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

69.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ugarte (38 Years) 38 Yrs

Hanover Specialty Average (35.7 Years) 35.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	208	148	$178.00	$80.49
99202 New patient office or other outpatient visit, typically 20 minutes	78	78	$158.00	$63.91
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	75	34	$167.71	$69.15
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	64	64	$667.00	$220.94
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	45	44	$355.20	$114.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	45	40	$113.00	$49.99
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	43	43	$613.00	$156.66
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	39	$408.50	$151.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	34	34	$247.00	$98.72
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	32	30	$39.00	$15.75
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	29	29	$567.00	$157.12
45380 Biopsy of large bowel using an endoscope	27	27	$588.00	$108.18
47562 Removal of gallbladder using an endoscope	23	23	$1507.00	$582.87
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	21	21	$1533.00	$281.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	18	$251.00	$115.31
49650 Repair of groin hernia using an endoscope	19	19	$1003.95	$443.61
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	16	$466.00	$77.01
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	15	15	$345.00	$79.29
45378 Diagnostic exam of large bowel using a flexible endoscope	15	15	$451.00	$161.48
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$377.00	$88.22
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)	11	11	$336.00	$73.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	174	126	$173.52	$86.08
99202 New patient office or other outpatient visit, typically 20 minutes	56	56	$160.38	$68.26
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	50	27	$167.22	$76.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$246.50	$107.18
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	47	47	$886.45	$241.63
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	42	35	$106.52	$53.04
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	41	41	$657.49	$174.81
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	40	$444.80	$167.18
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$376.00	$159.35
45380 Biopsy of large bowel using an endoscope	29	28	$741.93	$118.11
45378 Diagnostic exam of large bowel using a flexible endoscope	23	23	$775.17	$176.24
47562 Removal of gallbladder using an endoscope	21	21	$1597.67	$635.84
49650 Repair of groin hernia using an endoscope	19	19	$940.37	$439.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	16	$246.00	$122.13
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	18	18	$497.56	$90.65
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	18	18	$1779.00	$308.48
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	17	17	$39.00	$17.30
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	16	16	$676.38	$175.12
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	12	$354.46	$125.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	147	102	$165.00	$88.15
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	82	33	$166.50	$68.90
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	65	63	$475.00	$191.85
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	49	49	$1240.00	$247.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	39	39	$376.00	$162.98
45378 Diagnostic exam of large bowel using a flexible endoscope	38	38	$917.00	$177.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$245.00	$108.70
45380 Biopsy of large bowel using an endoscope	31	31	$788.39	$96.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	27	$241.00	$124.63
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	17	$96.00	$54.79
47562 Removal of gallbladder using an endoscope	21	21	$1745.00	$635.41
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	19	19	$2640.00	$316.91
49650 Repair of groin hernia using an endoscope	19	19	$1105.26	$450.03
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	15	15	$917.00	$179.35
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	13	13	$917.00	$180.14
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$165.00	$70.59
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	12	12	$796.00	$86.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	135	102	$165.00	$89.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	66	61	$475.00	$195.79
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	63	26	$166.50	$70.28
45380 Biopsy of large bowel using an endoscope	44	44	$865.73	$119.99
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$376.00	$164.69
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	35	35	$1240.00	$250.95
45378 Diagnostic exam of large bowel using a flexible endoscope	35	35	$917.00	$183.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	27	$241.00	$123.46
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$245.00	$109.95
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	22	$96.00	$54.81
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	19	19	$687.00	$89.14
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	16	16	$917.00	$183.45
47562 Removal of gallbladder using an endoscope	16	16	$1745.00	$658.00
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$165.00	$71.28
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	12	12	$2640.00	$317.00
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	11	11	$760.00	$105.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	132	104	$165.00	$73.68
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	97	28	$166.50	$72.19
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	75	60	$475.00	$201.86
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	56	56	$1240.00	$259.39
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	48	48	$376.00	$160.95
45380 Biopsy of large bowel using an endoscope	44	44	$811.55	$105.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	35	$241.00	$106.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$245.00	$105.62
45378 Diagnostic exam of large bowel using a flexible endoscope	32	31	$917.00	$188.78
47562 Removal of gallbladder using an endoscope	24	24	$1745.00	$651.39
49650 Repair of groin hernia using an endoscope	18	18	$1111.11	$450.07
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$165.00	$74.62
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	16	$687.00	$108.91
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	15	15	$917.00	$188.48
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	14	14	$2640.00	$343.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	152	119	$165.00	$71.80
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	117	41	$166.50	$71.63
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	88	81	$475.00	$199.19
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	57	56	$1240.00	$260.54
45380 Biopsy of large bowel using an endoscope	55	55	$922.62	$139.74
45378 Diagnostic exam of large bowel using a flexible endoscope	55	55	$917.00	$189.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	52	52	$376.00	$160.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	45	45	$245.00	$105.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	42	35	$241.00	$105.68
47562 Removal of gallbladder using an endoscope	38	38	$1745.00	$666.08
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	20	$96.00	$43.49
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	24	24	$917.00	$188.07
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$165.00	$74.09
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	19	19	$687.00	$114.89
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	17	17	$917.00	$187.71
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	16	16	$2640.00	$340.25
49650 Repair of groin hernia using an endoscope	15	15	$1200.00	$489.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	163	123	$165.00	$70.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	68	68	$245.00	$105.03
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	65	58	$475.00	$200.07
45380 Biopsy of large bowel using an endoscope	62	62	$866.10	$132.47
45378 Diagnostic exam of large bowel using a flexible endoscope	62	62	$917.00	$186.79
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	61	27	$174.22	$71.81
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	44	44	$1240.00	$260.71
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	42	40	$241.00	$104.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	29	25	$96.00	$42.44
47562 Removal of gallbladder using an endoscope	27	27	$1745.00	$663.46
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$165.00	$72.78
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	24	24	$917.00	$188.61
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)	24	22	$555.00	$98.15
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	22	22	$593.73	$108.33
G0105 Colorectal cancer screening; colonoscopy on individual at high risk	15	15	$917.00	$188.24
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	15	15	$716.20	$122.29
49505 Repair of groin hernia (5 years or older)	14	14	$1296.43	$560.16
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	13	13	$2538.46	$327.90
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$376.00	$160.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	175	130	$165.00	$70.10
45380 Biopsy of large bowel using an endoscope	90	90	$864.22	$131.05
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	82	25	$175.00	$70.79
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	65	60	$475.00	$198.77
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	60	60	$245.00	$104.56
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	52	46	$241.00	$102.32
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	51	51	$1240.00	$259.04
45378 Diagnostic exam of large bowel using a flexible endoscope	50	50	$917.00	$184.83
47562 Removal of gallbladder using an endoscope	38	38	$1745.00	$644.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	21	$96.00	$41.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$376.00	$159.12
G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	19	19	$917.00	$182.54
43235 Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope	19	19	$633.00	$111.64
99202 New patient office or other outpatient visit, typically 20 minutes	17	17	$165.00	$72.34
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	16	15	$671.19	$119.01
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)	13	12	$555.00	$121.37
49505 Repair of groin hernia (5 years or older)	12	12	$1260.42	$541.13

Medical Specialties & State Licenses

CMS Verified: 2023-11-06

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License PA MD052860L

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Specialist

NUCC Taxonomy Code: 174400000X

State License PA MD052860L

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

01482530 (PA)

Commercial Insurance / Payer ID Capital Blue Cross

01102001 (PA)

Commercial Insurance / Payer ID Unison

114970 (PA)

Commercial Insurance / Payer ID Keystone Health Plan

991821 (PA)

Commercial Insurance / Payer ID Highmark Blue Shield

UG439130 (PA)

Commercial Insurance / Payer ID Gateway

1519061 (PA)

Hospital & Practice Group Affiliations

Pinnacle Health Medical Services

2501 N 3rd St, Harrisburg, PA 171101904

Phone: 7177822100

Pinnacle Health Medical Services

2501 N 3rd Street 2nd Floor, Harrisburg, PA 171101904

Phone: 7177822143

Pinnacle Health Medical Services

300 Highland Ave, Hanover, PA 173312297

Phone: 7173163711

Pinnacle Health Medical Services

401 Allegheny Ave, Hanover, PA 173311957

Phone: 7176302844

Pinnacle Health Medical Services

2501 N 3rd St Fl, Harrisburg, PA 171101904

Phone: 7177822100

Pinnacle Health Medical Services

2501 N 3rd St 2nd Fl Kline Hc, Harrisburg, PA 171101904

Phone: 7177822363

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Richard Campbell , MA

Psychologist

NPI 1053364240

Master of Arts

Dr. Richard Carlson , PhD

Psychologist - Clinical

NPI 1972529659

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 20, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location July 20, 2016

Registered at 401 ALLEGHENY AVE, HANOVER, PA 173311949 (Tel: 7176302844)

📍

Updated Business Mailing Address July 20, 2016

Registered at 401 ALLEGHENY AVE, HANOVER, PA 173311949 (Tel: 7176302844)

👤

Provider Name / Credentials Updated July 20, 2016

Recorded as MARCOS UGARTE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2016

Specialist (License #MD052860L in PA)

🟢

Initial NPI Registration & Enumeration July 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1386661155

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 16, 2006

Last Update: November 06, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

401 Allegheny Ave

Hanover, PA 173311949

Phone: 7176302844

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.