DR. SAM J BIAFORA M.D.
NPI 1205037991
Orthopaedic Surgery - Hand Surgery in Crystal Lake, IL

Q: What is Sam Biafora's NPI number?

The NPI number for Sam Biafora is 1205037991. It was assigned to this individual provider in the NPPES registry on May 30, 2007.

Q: What is Sam Biafora's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Q: When was this NPI record last updated?

The NPPES record for Sam Biafora was last updated on August 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since May 30, 2007PECOS EnrolledAccepts Medicare Assignment

420 N IL ROUTE 31, CRYSTAL LAKE, IL 60012(815) 356-5200(815) 356-5262 Get Directions Write a Review

NPPES record last updated: August 18, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Sam J Biafora M.d. NPPES

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

DR. SAM J BIAFORA M.D. (NPI 1205037991) is an individual hand surgery provider in Crystal Lake, Illinois, licensed in Illinois (036-115378) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Northwest Community Hospital 1, and is a graduate of Chicago College Of Medicine And Surgery (2002).

NPPES Registry Identity

NPI1205037991

Entity TypeIndividualMale

Primary Taxonomy207XS0106X

Provider Legal NameDR. SAM J BIAFORACredential: M.D.

Location Address420 N IL ROUTE 31Crystal Lake, IL 60012-3711

Mailing Address420 N Il Route 31Crystal Lake, IL 60012-3711 · (815) 356-5200 · Fax (815) 356-5262

Phone(815) 356-5200

Fax(815) 356-5262

Sole ProprietorNo

Medical School CMSChicago College Of Medicine And SurgeryGraduated 2002

Enumeration DateMay 30, 2007

Last NPPES UpdateAugust 18, 2008

✔ NPI 1205037991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207XS0106X

License✔ Licensed in IL · 036-115378

Definition

An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

420 N IL ROUTE 31, Crystal Lake, IL 60012

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Other Identifiers 2

Medicaid036115378IL

Medicare PINR02210

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

Dr. Sam J Biafora 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 ID2264506203

PECOS Enrollment IDI20080808000355

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 11

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.

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

193 services36 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.

114 services67 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

97 services53 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

56 services40 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

54 services54 patients

X-ray of finger, minimum of 2 views 73140

An X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.

45 services32 patients

Hospital Affiliations CMS Care Compare 2

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

Northwest Community Hospital 1

Acute Care Hospitals · Arlington Heights, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140252

Location800 W Central RoadArlington Heights, IL 60005 · Cook County

Emergency services Birthing friendly

Alexian Brothers Medical Center 1

Acute Care Hospitals · Elk Grove Village, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140258

Location800 Biesterfield RdElk Grove Village, IL 60007 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60012 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

90%2,349 patients4/55-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.

94%52 patients4/55-star benchmark: 99%

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.

47%571 patients1/55-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.

69%824 patients3/55-star benchmark: 97%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

21%674 patients1/55-star benchmark: 97%

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…

87%824 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%824 patients1/55-star benchmark: 89%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 150 patients

1%150 patients4/55-star benchmark: 100%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

7%824 patients

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

93%43 patients

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.

NORTHERN ILLINOIS MEDICAL CENTER

Durable Medical Equipment & Medical Supplies