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MR. MOHAMED A ELRAFEI MD
NPI 1114955895
Psychiatry & Neurology - Psychiatry in Wayne, NJ

Active since June 29, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
401 HAMBURG TPKE, SUIT 303, WAYNE, NJ 07470(973) 790-9222(973) 790-0871 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Mohamed A Elrafei Md NPPES

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

MR. MOHAMED A ELRAFEI MD (NPI 1114955895) is an individual psychiatry provider in Wayne, New Jersey, licensed in New Jersey (MA050857) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1982).

NPPES Registry Identity

NPI1114955895
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameMR. MOHAMED A ELRAFEICredential: MD
Location Address401 HAMBURG TPKE, SUIT 303Wayne, NJ 07470-2154
Mailing Address794 Peach Tree LnFranklin Lakes, NJ 07417-2333 · (973) 790-9222 · Fax (973) 790-0671
Phone(973) 790-9222
Fax(973) 790-0871
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateJune 29, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1114955895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in NJ · MA050857
Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

401 HAMBURG TPKE, Wayne, NJ 07470
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Other Identifiers 2

Medicare UPINE54572NJ
Medicare ID-Type Unspecified623972NJ · Medicare Number

Accepted Insurance

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

Mr. Mohamed A Elrafei 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 ID2163438243
PECOS Enrollment IDI20060227000543
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 13

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.

Psychotherapy with evaluation and management visit, 30 minutes 90833
Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.
657 services148 patients
Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management 90868
This treatment involves using a magnetic field to activate nerve cells in the brain. It's a non-invasive procedure designed to manage conditions like depression. The magnetic field is precisely targeted to stimulate specific areas of the brain to improve symptoms.
436 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
425 services130 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
319 services111 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
192 services80 patients
Evaluation of neuropsychological test, first hour 96132
An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.
129 services68 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07470 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
$190.92 typical visit price
range $63.84 – $190.92
Typical copayment $47.73 (range $15.96 – $47.73)
Most-billed visit code 99205
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored

Reported Quality Measures

Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management
Percentage of patients with dementia for whom there was a documented symptoms screening* for behavioral and psychiatric symptoms, including depression, AND for whom, if symptoms screening was positive, there was also documentation of recommendations for…
100%305 patients5/55-star benchmark: 100%
Dementia: Caregiver Education and Support
Percentage of patients with dementia whose caregiver(s)* were provided with education** on dementia disease management and health behavior changes AND were referred to additional resources*** for support in the last 12 months
100%305 patients5/55-star benchmark: 100%
Dementia: Functional Status Assessment
Percentage of patients with dementia for whom an assessment of functional status* was performed at least once in the last 12 months
100%305 patients5/55-star benchmark: 100%
Dementia: Safety Concerns Screening and Mitigation Recommendations or Referral for Patients with Dementia
Percentage of patients with dementia or their caregiver(s) for whom there was a documented safety concerns screening * in two domains of risk: 1) dangerousness to self or others and 2) environmental risks; and if safety concerns screening was positive in the…
100%305 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%3,245 patients5/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
65%371 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
75%1,001 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,001 patients5/55-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.

Other Providers at the Same Location NPPES 20

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

EYAD NAYAL M.D.
Psychiatry & Neurology (Neurology)
401 HAMBURG TPKE, SUITE# 208
WAYNE, NJ 07470
Passaic County (973) 942-3300
LINDA B BERGER RN APN
Nurse Practitioner (Psychiatric/Mental Health)
401 HAMBURG TPKE, STE 303
WAYNE, NJ 07470
Passaic County (973) 790-9222
PHILIP BAI, M.D. LLC.
Specialist
401 HAMBURG TPKE, SUITE 101
WAYNE, NJ 07470
Passaic County (973) 925-4601
ROBERT TARTAGLIA D.S.
Chiropractor
401 HAMBURG TPKE
WAYNE, NJ 07470
Passaic County (201) 264-2099
MARIPAT ALGER COTTONE APRN BC
Nurse Practitioner (Psychiatric/Mental Health)
401 HAMBURG TPKE, SUITE 303
WAYNE, NJ 07470
Passaic County (973) 790-9222
MR. REZA FARHANGFAR MD
Internal Medicine (Pulmonary Disease)
401 HAMBURG TPKE, SUITE 107
WAYNE, NJ 07470
Passaic County (973) 595-7456
MR. NIDAL MATALKAH MD
Internal Medicine (Pulmonary Disease)
401 HAMBURG TPKE, SUITE 107
WAYNE, NJ 07470
Passaic County (973) 595-7456
DR. SHAKEEL A. QAZI DPT
Physical Therapist
401 HAMBURG TPKE, SUITE 204
WAYNE, NJ 07470
Passaic County (973) 790-9010

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 Mohamed Elrafei's NPI number?

The NPI number for Mohamed Elrafei is 1114955895. It was assigned to this individual provider in the NPPES registry on June 29, 2006.

Where is Mohamed Elrafei located?

Mohamed Elrafei practices at 401 Hamburg Tpke Suit 303, Wayne, NJ 07470. The listed phone number is (973) 790-9222.

What is Mohamed Elrafei's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Mohamed Elrafei enrolled in Medicare?

Yes. Mohamed Elrafei 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 Mohamed Elrafei accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Providence Health Plan list Mohamed Elrafei 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.

When was this NPI record last updated?

The NPPES record for Mohamed Elrafei was last updated on July 9, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.