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DR. RAFATH KHATOON HUMERA M.D
NPI 1376871202
Internal Medicine in Clifton, NJ

Active since December 04, 2009PECOS EnrolledAccepts Medicare Assignment
535 GETTY AVE, SUITE-3(PARK AVE MEDICAL CENTER), CLIFTON, NJ 07011(973) 782-4905(973) 782-4893 Get Directions Write a Review

NPPES record last updated: October 2, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Rafath Khatoon Humera M.d NPPES

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

DR. RAFATH KHATOON HUMERA M.D (NPI 1376871202) is an individual internal medicine provider in Clifton, New Jersey, licensed in New Jersey (25MA08760600) and active in the NPI registry since December 2009. She is enrolled in Medicare PECOS, is affiliated with St Joseph's University Medical Center Inc, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1376871202
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. RAFATH KHATOON HUMERACredential: M.D
Location Address535 GETTY AVE, SUITE-3(PARK AVE MEDICAL CENTER)Clifton, NJ 07011-2105
Mailing Address1367 Ratzer RdWayne, NJ 07470-2429 · (973) 333-3875
Phone(973) 782-4905
Fax(973) 782-4893
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateDecember 4, 2009
Last NPPES UpdateOctober 2, 2013
✔ NPI 1376871202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NJ · 25MA08760600✔ Licensed in NY · 256036
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.
535 GETTY AVE, Clifton, NJ 07011
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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. Rafath Khatoon Humera 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 ID3476681958
PECOS Enrollment IDI20110927000208
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 4

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 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.
158 services49 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
136 services26 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.
53 services32 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
30 services30 patients

Hospital Affiliations CMS Care Compare

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

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number310019
Location703 Main StPaterson, NJ 07503 · Passaic County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07011 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Reported Quality Measures

Colorectal Cancer Screening
48%474 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
72%285 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
14%244 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
20%244 patients4/55-star benchmark: 91%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
48%945 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
56%1,176 patients4/55-star benchmark: 61%
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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers22 claims52 services$5.84 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers14 claims23 services$0.98 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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PARK AVE MEDICAL CENTRE LLC
Internal Medicine
535 GETTY AVE, SUITE 3
CLIFTON, NJ 07011
Passaic County (862) 239-4808

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 Rafath Humera's NPI number?

The NPI number for Rafath Humera is 1376871202. It was assigned to this individual provider in the NPPES registry on December 4, 2009.

Where is Rafath Humera located?

Rafath Humera practices at 535 Getty Ave Suite-3(park Ave Medical Center), Clifton, NJ 07011. The listed phone number is (973) 782-4905.

What is Rafath Humera's specialty?

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

Is Rafath Humera enrolled in Medicare?

Yes. Rafath Humera 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 Rafath Humera accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Rafath Humera 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 Rafath Humera affiliated with any hospitals?

According to CMS data, Rafath Humera is affiliated with St Joseph's University Medical Center Inc.

When was this NPI record last updated?

The NPPES record for Rafath Humera was last updated on October 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.