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DR. RAFAEL AMARAL M.D.
NPI 1295719060
Internal Medicine - Gastroenterology in Darby, PA

Active since December 05, 2005PECOS EnrolledAccepts Medicare Assignment
1501 LANSDOWNE AVE, SUITE 205, DARBY, PA 19023(610) 534-6270(610) 534-6269 Get Directions Write a Review

NPPES record last updated: May 20, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 20, 2021, Apr 19, 2017 (2 updates tracked since 2017).

About Dr. Rafael Amaral M.d. NPPES

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

DR. RAFAEL AMARAL M.D. (NPI 1295719060) is an individual gastroenterology provider in Darby, Pennsylvania, licensed in Pennsylvania (MD044931E) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Mercy Catholic Medical Center- Mercy Fitzgerald, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1295719060
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. RAFAEL AMARALCredential: M.D.
Location Address1501 LANSDOWNE AVE, SUITE 205Darby, PA 19023-1333
Mailing Address41 University Dr Ste 106Newtown, PA 18940-1873
Phone(610) 534-6270
Fax(610) 534-6269
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateDecember 5, 2005
Last NPPES UpdateMay 20, 20212 updates tracked since enumeration
NPPES CertifiedMay 20, 2021
✔ NPI 1295719060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in PA · MD044931E
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.
1501 LANSDOWNE AVE, Darby, PA 19023
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Accepted Insurance

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

Dr. Rafael Amaral 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 ID7618924390
PECOS Enrollment IDI20050405000634
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.

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.
196 services138 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.
191 services89 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.
88 services80 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.
73 services66 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.
60 services60 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.
53 services50 patients

Hospital Affiliations CMS Care Compare 2

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

Mercy Catholic Medical Center- Mercy Fitzgerald

Acute Care Hospitals · Darby, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390156
Location1500 Lansdowne AveDarby, PA 19023 · Delaware County
Emergency services

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390174
Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19023 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

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.

ALI S AHMADINEJAD MD
Surgery
1501 LANSDOWNE AVE, SUITE 207
DARBY, PA 19023
Delaware County (610) 534-6210
DOUGLAS L. KEAGLE D.O. P.C.
Internal Medicine
1501 LANSDOWNE AVE, SUITE 101
DARBY, PA 19023
Delaware County (610) 534-6310
DR. ANDREW W MCGINNIS MD
Internal Medicine (Cardiovascular Disease)
1501 LANSDOWNE AVE, SUITE 104
DARBY, PA 19023
Delaware County (610) 534-6150
MERCY MANAGEMENT OF SEPA
Internal Medicine
1501 LANSDOWNE AVE, SUITE 101
DARBY, PA 19023
Delaware County (610) 534-6310
ALI S AHMADINEJAD MD
Surgery
1501 LANSDOWNE AVE, SIUTE 207
DARBY, PA 19023
Delaware County (610) 534-6210
NUTRITIONAL CARE CONSULTANTS, PC
Internal Medicine
1501 LANSDOWNE AVE, SUITE 108
DARBY, PA 19023
Delaware County (610) 534-6357
MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANIA
Surgery
1501 LANSDOWNE AVE, SUITE 305
DARBY, PA 19023
Delaware County (610) 534-6170
RICHARD A SEIFERT MD PC
Internal Medicine (Cardiovascular Disease)
1501 LANSDOWNE AVE, SUITE 303
DARBY, PA 19023
Delaware County (610) 586-5018

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 Amaral's NPI number?

The NPI number for Rafael Amaral is 1295719060. It was assigned to this individual provider in the NPPES registry on December 5, 2005.

Where is Rafael Amaral located?

Rafael Amaral practices at 1501 Lansdowne Ave Suite 205, Darby, PA 19023. The listed phone number is (610) 534-6270.

What is Rafael Amaral's specialty?

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

Is Rafael Amaral enrolled in Medicare?

Yes. Rafael Amaral 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 Amaral accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Rafael Amaral 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 Rafael Amaral affiliated with any hospitals?

According to CMS data, Rafael Amaral is affiliated with Mercy Catholic Medical Center- Mercy Fitzgerald and Thomas Jefferson University Hospital.

When was this NPI record last updated?

The NPPES record for Rafael Amaral was last updated on May 20, 2021. 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.