1. Home
  2. Directory
  3. Maryland
  4. Baltimore
  5. Hospitalist
  6. NPI Profile

RAUL HIEDRA MD
NPI 1033605787
Hospitalist in Baltimore, MD

Active since July 05, 2018PECOS EnrolledAccepts Medicare Assignment
92.44/100
CMS Quality Rating
5200 EASTERN AVE FL EAST2, BALTIMORE, MD 21224(410) 550-5018(410) 550-2972 Get Directions Write a Review

NPPES record last updated: July 15, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 15, 2021, Jul 5, 2018 (2 updates tracked since 2018).

About Raul Hiedra Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAUL HIEDRA MD (NPI 1033605787) is an individual hospitalist provider in Baltimore, Maryland, licensed in Maryland (D91637) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, is affiliated with Geisinger Wyoming Valley Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1033605787
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameRAUL HIEDRACredential: MD
Location Address5200 EASTERN AVE FL EAST2Baltimore, MD 21224-2734
Mailing Address6201 Greenleigh AveMiddle River, MD 21220-2004 · (410) 933-6423
Phone(410) 550-5018
Fax(410) 550-2972
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJuly 5, 2018
Last NPPES UpdateJuly 15, 20212 updates tracked since enumeration
NPPES CertifiedJuly 15, 2021
✔ NPI 1033605787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in MD · D91637
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License D91637 (MD), MT214834 (PA)
5200 EASTERN AVE FL EAST2, Baltimore, MD 21224
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Raul Hiedra Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860894664
PECOS Enrollment IDI20231120000516
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
500 services236 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
204 services196 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
163 services98 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
21 services21 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390270
Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.44/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.49
Promoting Interoperability95.58
Improvement Activities40

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARGARET ANNE MALLARI DO
Internal Medicine
5200 EASTERN AVE FL EAST2
BALTIMORE, MD 21224
Baltimore City (410) 550-5018
DR. KATHLEEN PENCEK MD
Internal Medicine
5200 EASTERN AVE FL EAST2
BALTIMORE, MD 21224
Baltimore City (410) 550-5018
DR. AMTESHWAR SINGH M.B.B.S., M.D.
Internal Medicine
5200 EASTERN AVE FL EAST2
BALTIMORE, MD 21224
Baltimore City (410) 550-5018

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raul Hiedra's NPI number?

The NPI number for Raul Hiedra is 1033605787. It was assigned to this individual provider in the NPPES registry on July 5, 2018.

Where is Raul Hiedra located?

Raul Hiedra practices at 5200 Eastern Ave Fl East2, Baltimore, MD 21224. The listed phone number is (410) 550-5018.

What is Raul Hiedra's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Raul Hiedra enrolled in Medicare?

Yes. Raul Hiedra is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Raul Hiedra accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Raul Hiedra as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Raul Hiedra affiliated with any hospitals?

According to CMS data, Raul Hiedra is affiliated with Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Raul Hiedra was last updated on July 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.