DR. RAFAEL FONSECA M.D.
NPI 1275517898
Internal Medicine - Hematology in Scottsdale, AZ

Q: What is Rafael Fonseca's NPI number?

The NPI number for Rafael Fonseca is 1275517898. It was assigned to this individual provider in the NPPES registry on December 6, 2005.

Q: What is Rafael Fonseca's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Q: When was this NPI record last updated?

The NPPES record for Rafael Fonseca was last updated on September 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 December 06, 2005PECOS EnrolledAccepts Medicare Assignment

78.58/100

CMS Quality Rating

13400 E SHEA BLVD, SCOTTSDALE, AZ 85259(480) 301-8000 Get Directions Write a Review

NPPES record last updated: September 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 3, 2020, Mar 13, 2019, May 10, 2018 (3 updates tracked since 2018).

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About Dr. Rafael Fonseca M.d. NPPES

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

DR. RAFAEL FONSECA M.D. (NPI 1275517898) is an individual hematology provider in Scottsdale, Arizona, licensed in Arizona (32565) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1275517898

Entity TypeIndividualMale

Primary Taxonomy207RH0000X

Provider Legal NameDR. RAFAEL FONSECACredential: M.D.

Location Address13400 E SHEA BLVDScottsdale, AZ 85259-5404

Mailing Address13400 E Shea BlvdScottsdale, AZ 85259-5404 · (480) 301-8000

Phone(480) 301-8000

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateDecember 6, 2005

Last NPPES UpdateSeptember 3, 20203 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2020

✔ NPI 1275517898 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0000X

License✔ Licensed in AZ · 32565

Definition

An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.

13400 E SHEA BLVD, Scottsdale, AZ 85259

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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. Rafael Fonseca 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 ID244221455

PECOS Enrollment IDI20040708000645

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 2

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.

224 services116 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.

20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85259 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

$168.60 typical visit price

range $55.44 – $168.60

Typical copayment $42.15 (range $13.86 – $42.15)

Most-billed visit code 99205

Established Patient

$98.00 typical visit price

range $17.72 – $137.41

Typical copayment $24.50 (range $4.43 – $34.35)

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.

78.58/100

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

Scored as part of a group practice

Quality

69.05

Promoting Interoperability

100

Improvement Activities

Cost

59.56

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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.

AMITKUMAR MEHTA MD

Internal Medicine (Hematology & Oncology)