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FRANCESCA NICOLE RAFFA M.D.
NPI 1164876165
Internal Medicine - Gastroenterology in Doral, FL

Active since April 16, 2016PECOS EnrolledAccepts Medicare Assignment
89.89/100
CMS Quality Rating
8375 NW 53RD ST, DORAL, FL 33166(305) 243-8644 Get Directions Write a Review

NPPES record last updated: July 23, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 23, 2024, Oct 10, 2022, Sep 25, 2016 (3 updates tracked since 2016).

About Francesca Nicole Raffa M.d. NPPES

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

FRANCESCA NICOLE RAFFA M.D. (NPI 1164876165) is an individual gastroenterology provider in Doral, Florida, licensed in Florida (ME168702) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Miami, Lm Miller School Of Medicine (2011).

NPPES Registry Identity

NPI1164876165
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameFRANCESCA NICOLE RAFFACredential: M.D.
Location Address8375 NW 53RD STDoral, FL 33166-4611
Mailing Address8375 Nw 53rd StDoral, FL 33166-4611 · (305) 243-8644
Phone(305) 243-8644
Sole ProprietorNo
Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 2011
Enumeration DateApril 16, 2016
Last NPPES UpdateJuly 23, 20243 updates tracked since enumeration
NPPES CertifiedJuly 23, 2024
✔ NPI 1164876165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in FL · ME168702
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
8375 NW 53RD ST, Doral, FL 33166
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11400 NW 12th AveMiami, FL 33136-1003 · Phone (305) 243-4000
Location 21611 NW 12th AveMiami, FL 33136-1005 · Phone (305) 243-4000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) 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

Francesca Nicole Raffa 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 ID3072993369
PECOS Enrollment IDI20240821000019
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 8

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.
42 services37 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.
34 services24 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.
24 services24 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.
21 services21 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
16 services16 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.
13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33166 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

89.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality79.78
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 15

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

DR. MICHAEL J PLAZA M.D.
Radiology (Diagnostic Radiology)
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (305) 243-1815
MRS. BRENDA NGUYEN LIU
Physician Assistant
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (305) 243-8644
JAVIER DANIEL LUCES
Nurse Anesthetist, Certified Registered
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (305) 689-8375
JANET HERNANDEZ ARNP
Nurse Practitioner
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (305) 243-8644
ELAN ESTERSON
Nurse Anesthetist, Certified Registered
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (305) 689-8375
DR. DENNIS JAMES WARFIELD JR. M.D.
Anesthesiology
8375 NW 53RD ST
MIAMI, FL 33166
Miami-Dade County (305) 689-8375
GONZALO FERNANDO RUBIES SA
Specialist/Technologist, Other (Surgical Assistant)
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (786) 767-9080
PATRICK CUVET CRNA
Nurse Anesthetist, Certified Registered
8375 NW 53RD ST
DORAL, FL 33166
Miami-Dade County (305) 689-8375

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 Francesca Raffa's NPI number?

The NPI number for Francesca Raffa is 1164876165. It was assigned to this individual provider in the NPPES registry on April 16, 2016.

Where is Francesca Raffa located?

Francesca Raffa practices at 8375 NW 53rd St, Doral, FL 33166. The listed phone number is (305) 243-8644.

What is Francesca Raffa's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Francesca Raffa enrolled in Medicare?

Yes. Francesca Raffa 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 Francesca Raffa accept?

Health plans from AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and Oscar Health Maintenance Organization of Florida and 1 other insurer list Francesca Raffa 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 Francesca Raffa was last updated on July 23, 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.