1. Home
  2. Directory
  3. Texas
  4. San Antonio
  5. Family Medicine
  6. NPI Profile

RAFAEL JORGE FORNARIS M.D.
NPI 1083742829
Family Medicine in San Antonio, TX

Active since March 01, 2007PECOS EnrolledAccepts Medicare Assignment
16.39/100
CMS Quality Rating
434 NW LOOP 1604, SUITE 1204, SAN ANTONIO, TX 78232(210) 946-6677 Get Directions Write a Review

NPPES record last updated: April 21, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rafael Jorge Fornaris M.d. NPPES

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

RAFAEL JORGE FORNARIS M.D. (NPI 1083742829) is an individual family medicine provider in San Antonio, Texas, licensed in Texas (M5165) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospital Stone Oak, and is a graduate of University Of Texas Southwestern Medical School At Dallas (2004).

NPPES Registry Identity

NPI1083742829
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRAFAEL JORGE FORNARISCredential: M.D.
Location Address434 NW LOOP 1604, SUITE 1204San Antonio, TX 78232
Mailing Address863 Celestial VwSan Antonio, TX 78260-4374 · (210) 833-0389
Phone(210) 946-6677
Sole ProprietorYes
Medical School CMSUniversity Of Texas Southwestern Medical School At DallasGraduated 2004
Enumeration DateMarch 1, 2007
Last NPPES UpdateApril 21, 2020
NPPES CertifiedApril 21, 2020
✔ NPI 1083742829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · M5165
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
434 NW LOOP 1604, San Antonio, TX 78232
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Imperial Insurance Companies, Inc. and more.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

Rafael Jorge Fornaris M.d. 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 ID5698833655
PECOS Enrollment IDI20081020000245
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 6

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.
949 services276 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.
278 services256 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.
161 services151 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.
135 services94 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
44 services25 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Methodist Hospital Stone Oak

Acute Care Hospitals · San Antonio, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number670055
Location1139 E Sonterra Blvd,San Antonio, TX 78258 · Bexar County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78232 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

16.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost54.66

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
21%57 patients1/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
6 suppliers62 claims62 services$14.40 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers96 claims96 services$62.99 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$30.63 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
2 suppliers17 claims17 services$12.93 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$31.85 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Rafael Fornaris's NPI number?

The NPI number for Rafael Fornaris is 1083742829. It was assigned to this individual provider in the NPPES registry on March 1, 2007.

Where is Rafael Fornaris located?

Rafael Fornaris practices at 434 NW Loop 1604 Suite 1204, San Antonio, TX 78232. The listed phone number is (210) 946-6677.

What is Rafael Fornaris's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Rafael Fornaris enrolled in Medicare?

Yes. Rafael Fornaris 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 Rafael Fornaris accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Imperial Insurance Companies, Inc., Molina Healthcare and Oscar Insurance Company and 2 other insurers list Rafael Fornaris 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 Rafael Fornaris affiliated with any hospitals?

According to CMS data, Rafael Fornaris is affiliated with Methodist Hospital Stone Oak.

When was this NPI record last updated?

The NPPES record for Rafael Fornaris was last updated on April 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.