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DR. THOMAS A. RAFALSKI M.D.
NPI 1336176734
Internal Medicine in Newport, OR

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment
93.57/100
CMS Quality Rating
930 SW ABBEY ST, NEWPORT, OR 97365(541) 265-2244 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Thomas A. Rafalski M.d. NPPES

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

DR. THOMAS A. RAFALSKI M.D. (NPI 1336176734) is an individual internal medicine provider in Newport, Oregon, licensed in Oregon (MD15753) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Samaritan Pacific Community Hospital, and is a graduate of Indiana University School Of Medicine (1985).

NPPES Registry Identity

NPI1336176734
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. THOMAS A. RAFALSKICredential: M.D.
Location Address930 SW ABBEY STNewport, OR 97365-4820
Mailing AddressPo Box 2847Corvallis, OR 97339-2847
Phone(541) 265-2244
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1985
Enumeration DateJune 28, 2006
Last NPPES UpdateNovember 3, 2020
NPPES CertifiedNovember 3, 2020
✔ NPI 1336176734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OR · MD15753
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
930 SW ABBEY ST, Newport, OR 97365
Open in Google Maps ↗

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. Thomas A. Rafalski 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 ID5496733040
PECOS Enrollment IDI20040709001043
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

5

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

Samaritan Pacific Health Services Inc
Same address
Medicare Defined Swing Bed Unit
930 SW ABBEY ST
Newport, OR 97365
  • Reassigned Medicare billing, Oregon enrollment
  • 332 clinicians in this Medicare group
NPI 1518015593 (541) 265-2244
Mid-Valley Healthcare Inc
3.5 mi
Addiction Medicine
5840 NW BIGGS ST STE A
Newport, OR 97365
  • Reassigned Medicare billing, Oregon enrollment
  • Also billed through NPI 1073879227 (Oregon)
  • 416 clinicians in this Medicare group
NPI 1740087899 (541) 574-7202
Samaritan North Lincoln Hospital
24 mi
Rural Health
825 NW HIGHWAY 101 STE A
Lincoln City, OR 97367
  • Reassigned Medicare billing, Oregon enrollment
  • Also billed through NPI 1245599224 (Oregon)
  • 277 clinicians in this Medicare group
NPI 1396893327 (541) 996-7480
Good Samaritan Hospital Corvallis
37 mi
Family Medicine
5234 PHILOMATH BOULEVARD
Corvallis, OR 97333
  • Reassigned Medicare billing, Oregon enrollment
  • 522 clinicians in this Medicare group
NPI 1427323690 (541) 768-4970
Albany General Hospital
46 mi
Family Medicine
1086 7TH AVE SW STE 101
Albany, OR 97321
  • Reassigned Medicare billing, Oregon enrollment
  • 432 clinicians in this Medicare group
NPI 1306679816 (541) 812-5530

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 6

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
118 services54 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
76 services72 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
50 services32 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.
33 services25 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
32 services31 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.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Samaritan Pacific Community Hospital

Critical Access Hospitals · Newport, OR
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number381314
Location930 SW Abbey StreetNewport, OR 97365 · Lincoln County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97365 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
$126.25 typical visit price
range $54.96 – $166.64
Typical copayment $31.56 (range $13.74 – $41.66)
Most-billed visit code 99204
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
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.

93.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.33
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier27 claims27 services$18.93 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier28 claims28 services$110.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

SAMARITAN PACIFIC HEALTH SERVICES INC
Pharmacy (Institutional Pharmacy)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4840
DEBRA PANKIEWICZ MD
Internal Medicine
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 265-2244
KAREN G. KOZICK RD, CDE
Nutritionist (Nutrition, Education)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-1815
CODY SHANE ALLISON BS, ACSM-CEP
Clinical Exercise Physiologist
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4856
JEAN M FREDRICKSON LCSW
Social Worker (Clinical)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-1811
MR. RICHARD KASEY CRAVEN CSFA
Technician/Technologist
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4972
SAMARITAN PACIFIC HEALTH SERVICES INC
Medicare Defined Swing Bed Unit
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 265-2244
NICOLE JOLIN RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4840

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 Thomas Rafalski's NPI number?

The NPI number for Thomas Rafalski is 1336176734. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Thomas Rafalski located?

Thomas Rafalski practices at 930 SW Abbey St, Newport, OR 97365. The listed phone number is (541) 265-2244.

What is Thomas Rafalski's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thomas Rafalski enrolled in Medicare?

Yes. Thomas Rafalski 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.

Which organizations bill Medicare for Thomas Rafalski's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Rafalski reassigns Medicare benefits to 5 organizations: Samaritan Pacific Health Services Inc (Newport, OR), Mid-Valley Healthcare Inc (Newport, OR), Samaritan North Lincoln Hospital (Lincoln City, OR), Good Samaritan Hospital Corvallis (Corvallis, OR) and Albany General Hospital (Albany, OR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Rafalski's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Thomas Rafalski affiliated with any hospitals?

According to CMS data, Thomas Rafalski is affiliated with Samaritan Pacific Community Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Rafalski was last updated on November 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.