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KHALIL A RAFFOUL M.D.
NPI 1407851736
Ophthalmology in Toledo, OH

Active since June 14, 2005PECOS EnrolledAccepts Medicare Assignment
1000 REGENCY CT, STE 100, TOLEDO, OH 43623(419) 882-0588(419) 885-3070 Get Directions Write a Review

NPPES record last updated: April 13, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Khalil A Raffoul M.d. NPPES

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

KHALIL A RAFFOUL M.D. (NPI 1407851736) is an individual ophthalmology provider in Toledo, Ohio, licensed in Ohio (35070799) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (1991).

NPPES Registry Identity

NPI1407851736
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameKHALIL A RAFFOULCredential: M.D.
Location Address1000 REGENCY CT, STE 100Toledo, OH 43623-3074
Mailing Address1000 Regency Ct, Ste 100Toledo, OH 43623-3074 · (419) 882-0588 · Fax (419) 885-3070
Phone(419) 882-0588
Fax(419) 885-3070
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1991
Enumeration DateJune 14, 2005
Last NPPES UpdateApril 13, 2021
NPPES CertifiedApril 13, 2021
✔ NPI 1407851736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in OH · 35070799
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.
1000 REGENCY CT, Toledo, OH 43623
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Other Identifiers 6

Medicaid0297450OH
Other180027814OH · Railroad Medicare
Other000000127266Anthem
Other02267Paramount
Other0004651135Aetna
Other1427801United Healthcare

Accepted Insurance

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

Khalil A Raffoul 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 ID2264548221
PECOS Enrollment IDI20101008000178
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 12

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 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.
376 services356 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.
284 services228 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.
250 services202 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.
129 services101 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).
107 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.
83 services77 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43623 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

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.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
3 suppliers17 claims17 services$61.03 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers12 claims21 services$59.09 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 14

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

DR. ISABELLA SWADE DNP, FNP-BC
Nurse Practitioner
1000 REGENCY CT
TOLEDO, OH 43623
Lucas County (419) 479-2665
DR. YOUNGSOOK YOON M.D.
Internal Medicine (Pulmonary Disease)
1000 REGENCY CT
TOLEDO, OH 43623
Lucas County (419) 720-0317
ASHLEY CHRISTINE SCHNEIDER
Physical Medicine & Rehabilitation
1000 REGENCY CT
TOLEDO, OH 43623
Lucas County (419) 479-2665
CAROL J GERMAN O.D.
Optometrist
1000 REGENCY CT, STE 100
TOLEDO, OH 43623
Lucas County (419) 882-0588
DR. CHRISTINA PACIO TAM M.D.
Ophthalmology
1000 REGENCY CT, STE. 100
TOLEDO, OH 43623
Lucas County (419) 882-0588
DR. DANIEL FRANCIS SYDLOWSKI JR. DDS
Dentist (General Practice)
1000 REGENCY CT, SUITE 101
TOLEDO, OH 43623
Lucas County (419) 720-5005
MRS. SVETLANA STAHL
Nurse Practitioner (Acute Care)
1000 REGENCY CT, SUITE 102
TOLEDO, OH 43623
Lucas County (419) 517-8000
DINO J COSTA O.D.
Optometrist
1000 REGENCY CT, STE 100
TOLEDO, OH 43623
Lucas County (419) 882-0588

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 Khalil Raffoul's NPI number?

The NPI number for Khalil Raffoul is 1407851736. It was assigned to this individual provider in the NPPES registry on June 14, 2005.

Where is Khalil Raffoul located?

Khalil Raffoul practices at 1000 Regency Ct Ste 100, Toledo, OH 43623. The listed phone number is (419) 882-0588.

What is Khalil Raffoul's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Khalil Raffoul enrolled in Medicare?

Yes. Khalil Raffoul 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 Khalil Raffoul accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 9 other insurers list Khalil Raffoul 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.

When was this NPI record last updated?

The NPPES record for Khalil Raffoul was last updated on April 13, 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.