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RAAFIA MEMON M.D.
NPI 1144646738
Internal Medicine - Endocrinology, Diabetes & Metabolism in Newark, DE

Active since March 06, 2014PECOS EnrolledAccepts Medicare Assignment
4735 OGLETOWN STANTON RD STE 3201, NEWARK, DE 19713(302) 623-4323 Get Directions Write a Review

NPPES record last updated: July 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 30, 2024, Apr 23, 2020, Sep 5, 2019 and 1 more (4 updates tracked since 2015).

About Raafia Memon M.d. NPPES

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

RAAFIA MEMON M.D. (NPI 1144646738) is an individual endocrinology, diabetes & metabolism provider in Newark, Delaware, licensed in Delaware (C1-0013259) and active in the NPI registry since March 2014. She is enrolled in Medicare PECOS, is affiliated with Phillips County Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1144646738
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameRAAFIA MEMONCredential: M.D.
Location Address4735 OGLETOWN STANTON RD STE 3201Newark, DE 19713-2094
Mailing Address321 Dillon CirMiddletown, DE 19709-8365
Phone(302) 623-4323
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateMarch 6, 2014
Last NPPES UpdateJuly 30, 20244 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1144646738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Licenses✔ Licensed in DE · C1-0013259✔ Licensed in KS · 04-48316
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
4735 OGLETOWN STANTON RD STE 3201, Newark, DE 19713
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1254 Chapman Rd Ste 101DNewark, DE 19702-5489 · Phone (302) 240-6886
Location 21240 McKee RdDover, DE 19904-1381 · Phone (302) 672-5800
Location 3300 Biddle Ave Ste 201Newark, DE 19702-3972 · Phone (302) 661-3070

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of Kansas, Inc., Highmark Blue Cross Blue Shield 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

Raafia Memon 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 ID2961703657
PECOS Enrollment IDI20190827002891, I20231004003340
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.

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.
104 services101 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
94 services58 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.
48 services48 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.
45 services26 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.
25 services25 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
17 services17 patients

Hospital Affiliations CMS Care Compare 4

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

Phillips County Hospital

Critical Access Hospitals · Phillipsburg, KS
OwnershipGovernment - Local
CMS Certification Number171353
Location1150 State StreetPhillipsburg, KS 67661 · Phillips County
Emergency services

Greeley County Health Services

Critical Access Hospitals · Tribune, KS
OwnershipGovernment - Local
CMS Certification Number171359
Location506 3rd StreetTribune, KS 67879 · Greeley County
Emergency services

Goodland Regional Medical Center

Critical Access Hospitals · Goodland, KS
OwnershipGovernment - Local
CMS Certification Number171370
Location220 West Second StreetGoodland, KS 67735 · Sherman County
Emergency services

Smith County Memorial Hospital

Critical Access Hospitals · Smith Center, KS
OwnershipGovernment - Local
CMS Certification Number171377
Location921 E. Highway 36Smith Center, KS 66967 · Smith County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19713 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
$131.15 typical visit price
range $57.12 – $173.08
Typical copayment $32.78 (range $14.28 – $43.27)
Most-billed visit code 99204
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
41 suppliers108 claims415 services$5.67 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
19 suppliers36 claims79 services$0.92 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
17 suppliers336 claims341 services$185.95 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

STEPHANIE M O'CONNOR RD
Dietitian, Registered
4735 OGLETOWN STANTON RD STE 3201
NEWARK, DE 19713
New Castle County (302) 661-3070
MRS. BRITTANY ANNE PRICE RN, BSN, MSN
Registered Nurse (Diabetes Educator)
4735 OGLETOWN STANTON RD STE 3201
NEWARK, DE 19713
New Castle County (302) 623-4697
ALEXANDRA QUINN NURSE PRACTITIONER
Nurse Practitioner
4735 OGLETOWN STANTON RD STE 3201
NEWARK, DE 19713
New Castle County (302) 623-4323
DR. SHIVANI VEKARIA M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4735 OGLETOWN STANTON RD STE 3201
NEWARK, DE 19713
New Castle County (302) 623-4323

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 Raafia Memon's NPI number?

The NPI number for Raafia Memon is 1144646738. It was assigned to this individual provider in the NPPES registry on March 6, 2014.

Where is Raafia Memon located?

Raafia Memon practices at 4735 Ogletown Stanton Rd Ste 3201, Newark, DE 19713. The listed phone number is (302) 623-4323.

What is Raafia Memon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Raafia Memon enrolled in Medicare?

Yes. Raafia Memon 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 Raafia Memon accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of Kansas, Inc. and Highmark Blue Cross Blue Shield Delaware list Raafia Memon 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 Raafia Memon affiliated with any hospitals?

According to CMS data, Raafia Memon is affiliated with Phillips County Hospital, Greeley County Health Services, Goodland Regional Medical Center and Smith County Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Raafia Memon was last updated on July 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.