DR. RAFAEL MEDINA M.D.
NPI 1265416598
Ophthalmology in Cooperstown, NY

Q: What is Rafael Medina's NPI number?

The NPI number for Rafael Medina is 1265416598. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Q: What is Rafael Medina'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 Medina was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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 November 30, 2005PECOS EnrolledAccepts Medicare Assignment

86.64/100

CMS Quality Rating

1 ATWELL RD, COOPERSTOWN, NY 13326(607) 547-6960(607) 547-6574 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Dr. Rafael Medina M.d. NPPES

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

DR. RAFAEL MEDINA M.D. (NPI 1265416598) is an individual ophthalmology provider in Cooperstown, New York, licensed in New York (212374-1) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Aurelia Osborn Fox Memorial Hospital, and is a graduate of University Of Wisconsin School Of Medicine (1994).

NPPES Registry Identity

NPI1265416598

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. RAFAEL MEDINACredential: M.D.

Location Address1 ATWELL RDCooperstown, NY 13326-1301

Mailing Address1 Atwell RdCooperstown, NY 13326-1301 · (607) 547-3480

Phone(607) 547-6960

Fax(607) 547-6574

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1994

Enumeration DateNovember 30, 2005

Last NPPES UpdateOctober 14, 2025

NPPES CertifiedOctober 14, 2025

✔ NPI 1265416598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in NY · 212374-1

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.

1 ATWELL RD, Cooperstown, NY 13326

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Other Identifiers 1

Medicaid02110983NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Rafael Medina 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 ID143129023

PECOS Enrollment IDI20040108000953

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.

Medicare Billing Reassignments

Medicare enrollment records show Rafael Medina reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mary Imogene Bassett Hospital

Same address

Multi-Specialty

1 ATWELL RD
Cooperstown, NY 13326

Reassigned Medicare billing, New York enrollment
1,052 clinicians in this Medicare group

NPI 1083664221 (607) 547-6858

Bassett Hospital Of Schoharie County

22 mi

Critical Access

178 GRANDVIEW DR
Cobleskill, NY 12043

Reassigned Medicare billing, New York enrollment
202 clinicians in this Medicare group

NPI 1891862579 (518) 254-3456

Little Falls Hospital

24 mi

Critical Access

140 BURWELL ST
Little Falls, NY 13365

Reassigned Medicare billing, New York enrollment
202 clinicians in this Medicare group

NPI 1558321919 (315) 823-5281

O'connor Hospital

30 mi

Critical Access

460 ANDES RD
Delhi, NY 13753

Reassigned Medicare billing, New York enrollment
199 clinicians in this Medicare group

NPI 1891728192 (607) 746-0326

Kwiat Eye And Laser Surgery PLLC

42 mi

Ophthalmology

100 HOLLAND CIRCLE DR
Amsterdam, NY 12010

Reassigned Medicare billing, New York enrollment
19 clinicians in this Medicare group

NPI 1275763468 (518) 842-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 20

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 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.

136 services108 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.

113 services102 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.

101 services97 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.

94 services85 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

59 services59 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).

52 services50 patients

Imaging of retina 92134

51 services44 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

46 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.

46 services36 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

42 services42 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.

28 services28 patients

Exam of visual field with extended testing 92083

27 services26 patients

Removal of recurring cataract in lens capsule using a laser 66821

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

25 services20 patients

Imaging of optic nerve 92133

23 services23 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.

20 services16 patients

Ct scan of cornea 92025

A CT scan of the cornea is a non-invasive imaging test that uses X-rays to capture detailed pictures of your eye's cornea. It helps in diagnosing diseases or damage, planning for surgery, or evaluating the results of a treatment. It's a safe and painless procedure.

20 services20 patients

Ultrasound scan to determine eye length and lens power 76519

An ultrasound scan for the eye is a safe, non-invasive procedure. It uses sound waves to create images of your eye's structure. This helps determine the length of your eye and the power of your lens, which is crucial for diagnosing eye conditions and planning surgeries.

19 services19 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

19 services18 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

17 services17 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.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Aurelia Osborn Fox Memorial Hospital

Acute Care Hospitals · Oneonta, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330085

LocationOne Norton AvenueOneonta, NY 13820 · Otsego County

Emergency services

Bassett Healthcare

Acute Care Hospitals · Cooperstown, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330136

LocationOne Atwell RoadCooperstown, NY 13326 · Otsego County

Emergency services Birthing friendly

Little Falls Hospital

Critical Access Hospitals · Little Falls, NY

OwnershipVoluntary non-profit - Private

CMS Certification Number331311

Location140 Burwell StreetLittle Falls, NY 13365 · Herkimer County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13326 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

$126.40 typical visit price

range $54.87 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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.

86.64/100

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

Scored through an Alternative Payment Model

Quality

80.13

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

66%61 patients2/55-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.

SHIRLEY SCHUE ARNP

Nurse Practitioner (Pediatrics)