RAFAEL G ORTIZ MD
NPI 1225186067
Ophthalmology in Miami, FL

Q: What is Rafael Ortiz's NPI number?

The NPI number for Rafael Ortiz is 1225186067. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Q: What is Rafael Ortiz's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Rafael Ortiz was last updated on July 10, 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 January 08, 2007PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

11760 SW 40TH ST, STE 120, MIAMI, FL 33175(305) 220-2626(305) 220-2082 Get Directions Write a Review

NPPES record last updated: July 10, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Rafael G Ortiz Md NPPES

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

RAFAEL G ORTIZ MD (NPI 1225186067) is an individual ophthalmology provider in Miami, Florida, licensed in Florida (ME63943) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Miami, Lm Miller School Of Medicine (1988).

NPPES Registry Identity

NPI1225186067

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameRAFAEL G ORTIZCredential: MD

Location Address11760 SW 40TH ST, STE 120Miami, FL 33175-3582

Mailing Address11760 Sw 40th St, Ste 120Miami, FL 33175-3582 · (305) 220-2626 · Fax (305) 220-2082

Phone(305) 220-2626

Fax(305) 220-2082

Sole ProprietorYes

Medical School CMSUniversity Of Miami, Lm Miller School Of MedicineGraduated 1988

Enumeration DateJanuary 8, 2007

Last NPPES UpdateJuly 10, 2008

✔ NPI 1225186067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in FL · ME63943

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

11760 SW 40TH ST, Miami, FL 33175

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Other Identifiers 5

Medicaid373178200FL

Medicaid373178204FL

Medicare PIN18770FL

Medicare UPINF26740FL

Medicare PIN18770CFL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).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

Rafael G Ortiz 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 ID9931241197

PECOS Enrollment IDI20100126000636

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 14

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.

678 services289 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

640 services323 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

600 services328 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

455 services293 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

353 services223 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

224 services148 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

143 services100 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

130 services22 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.

65 services65 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

52 services42 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

48 services44 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

40 services19 patients

Compounded drug, not otherwise classified J7999

A compounded drug is a personalized medication created to meet unique patient needs. If you can't take standard drugs due to allergies or need a specific dosage not commercially available, a pharmacist can mix ingredients to make a drug specifically for you.

35 services12 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.

30 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33175 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

$75.86 typical visit price

range $18.99 – $150.24

Typical copayment $18.96 (range $4.74 – $37.56)

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.

100/100

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

Individually scored

Quality

100

Improvement Activities

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination

93%355 patients2/55-star benchmark: 100%

Diabetes: Eye Exam

100%175 patients5/55-star benchmark: 100%

Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

87%174 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

98%2,018 patients4/55-star benchmark: 100%

Overuse of Imaging for the Evaluation of Primary Headache

Lower rates are better for this measure.

0%37 patients

Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care

100%170 patients

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 577 patients

Patients totalRate: 0% · 577 patients

0%577 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.

DR. ASCENSION M TORRES M.D.

Surgery (Pediatric Surgery)

11760 SW 40TH ST, SUITE 722
MIAMI, FL 33175

Miami-Dade County (305) 559-1883

ROLANDO E LACAYO MD PA

Specialist

11760 SW 40TH ST, SUITE 311
MIAMI, FL 33175

Miami-Dade County (305) 553-1253

JULIO HENRY ACOSTA AGACNP

Nurse Practitioner (Acute Care)

11760 SW 40TH ST
MIAMI, FL 33175

Miami-Dade County (786) 863-0547

DR. FRANK DEPENA MD

Internal Medicine

11760 SW 40TH ST, SUITE 701
MIAMI, FL 33175

Miami-Dade County (305) 227-9339

TOMAS I MARIMON M.D.

Specialist

11760 SW 40TH ST, SUITE #518
MIAMI, FL 33175

Miami-Dade County (305) 553-2888

LORENZO J. NEGRET M.D. P.A.

Family Medicine

11760 SW 40TH ST, SUITE 433
MIAMI, FL 33175

Miami-Dade County (305) 223-9815

DR. LORENZO JOSE NEGRET M.D.

Family Medicine

11760 SW 40TH ST, STE 433
MIAMI, FL 33175

Miami-Dade County (305) 223-9815

JACK MAREK KLEM, MD PA

Neurological Surgery

11760 SW 40TH ST
MIAMI, FL 33175

Miami-Dade County (305) 223-3000

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 Rafael Ortiz's NPI number?

The NPI number for Rafael Ortiz is 1225186067. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Where is Rafael Ortiz located?

Rafael Ortiz practices at 11760 SW 40th St Ste 120, Miami, FL 33175. The listed phone number is (305) 220-2626.

What is Rafael Ortiz's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Rafael Ortiz enrolled in Medicare?

Yes. Rafael Ortiz 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 Rafael Ortiz accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Rafael Ortiz 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 Rafael Ortiz was last updated on July 10, 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.