WAEL REFAI MD
NPI 1205926789
Internal Medicine - Gastroenterology in Clinton Township, MI

Q: What is Wael Refai's NPI number?

The NPI number for Wael Refai is 1205926789. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Q: What is Wael Refai's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Wael Refai was last updated on March 21, 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.

Active since October 13, 2006PECOS EnrolledAccepts Medicare Assignment

84.32/100

CMS Quality Rating

15500 19 MILE RD STE 360, CLINTON TOWNSHIP, MI 48038(586) 649-9009 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 23, 2020, Oct 23, 2020, Dec 13, 2018 (3 updates tracked since 2018).

On this page

About Wael Refai Md NPPES

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

WAEL REFAI MD (NPI 1205926789) is an individual gastroenterology provider in Clinton Township, Michigan, licensed in Michigan (4301095430) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and maintains a secondary practice location in Rochester Hills.

NPPES Registry Identity

NPI1205926789

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameWAEL REFAICredential: MD

Location Address15500 19 MILE RD STE 360Clinton Township, MI 48038

Mailing Address133 S Main StMount Clemens, MI 48043-2308 · (586) 329-1880 · Fax (586) 329-1880

Phone(586) 649-9009

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateOctober 13, 2006

Last NPPES UpdateMarch 21, 20243 updates tracked since enumeration

NPPES CertifiedMarch 21, 2024

✔ NPI 1205926789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in MI · 4301095430

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.

Also ListedInternal Medicine · Transplant HepatologyTaxonomy 207RT0003X · License 4301095430 (MI)

15500 19 MILE RD STE 360, Clinton Township, MI 48038

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Secondary Practice Location 1

Location 11701 South Blvd E Ste 300, Center for Digestive HealthRochester Hills, MI 48307-6120 · Phone (248) 844-9710 · Fax (248) 844-9711

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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

Wael Refai 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 ID8820047558

PECOS Enrollment IDI20100218000586

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 12

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 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.

193 services127 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.

74 services74 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.

68 services68 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.

54 services26 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

44 services44 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.

38 services35 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

36 services36 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.

29 services28 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

28 services28 patients

Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384

This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.

27 services27 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

20 services17 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230047

Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County

Emergency services Birthing friendly

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230053

Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48038 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

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

84.32/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

82.24

Promoting Interoperability

100

Improvement Activities

Cost

65.51

Other Providers at the Same Location NPPES

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

LALITHA RUDRAIAH MD

Internal Medicine (Cardiovascular Disease)

15500 19 MILE RD STE 360
CLINTON TOWNSHIP, MI 48038

Macomb County (586) 649-9009

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 Wael Refai's NPI number?

The NPI number for Wael Refai is 1205926789. It was assigned to this individual provider in the NPPES registry on October 13, 2006.

Where is Wael Refai located?

Wael Refai practices at 15500 19 Mile Rd Ste 360, Clinton Township, MI 48038. The listed phone number is (586) 649-9009.

What is Wael Refai's specialty?

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

Is Wael Refai enrolled in Medicare?

Yes. Wael Refai 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 Wael Refai accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Wael Refai 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 Wael Refai affiliated with any hospitals?

According to CMS data, Wael Refai is affiliated with Henry Ford Macomb Hospital and Henry Ford Health Hospital.

When was this NPI record last updated?

The NPPES record for Wael Refai was last updated on March 21, 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.