DR. RAFAEL CARTAYA MD
Accepted Insurance for NPI 1417616632
General Practice in Miami, FL

Active since December 15, 2021PECOS EnrolledAccepts Medicare Assignment

0/100

CMS Quality Rating

8260 W FLAGLER ST STE 2I, MIAMI, FL 33144(786) 715-9183(786) 713-1115 Get Directions

NPPES record last updated: June 20, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Does Dr. Cartaya take my insurance?

83 Florida plans sold on HealthCare.gov for 2026 include Dr. Cartaya, from Oscar Health, Molina Healthcare, Ambetter Health and AmeriHealth Caritas Next. Insurers also list Dr. Cartaya in Alabama, Georgia, Illinois and Iowa.

InsurersOscar Health 33 plans Molina Healthcare 22 plans Ambetter Health 20 plans AmeriHealth Caritas Next 8 plans

Also listed inAlabama, Georgia, Illinois and Iowa

Call before you book: insurer directories can be out of date, so call the office at (786) 715-9183 to confirm your plan is accepted. These are Marketplace (ACA) plans only; employer, Medicare Advantage and Medicaid plans are not listed.

Florida plans 83 plans · 102 plan IDs

Plans sold to Florida residents. Costs are for the standard version of each plan. Insurers often sell the same plan under several plan IDs, one per service area; those share one row.

Oscar Health

33 plans · HMO

Accepting new patients

Individual Florida HMO network · 26 plans · Preferred tier

Gold Elite Saver Plus | with AdventHealthHMOGold$021525FL0010022

Gold Classic StandardHMOGold$2,00021525FL0020015

Gold Classic Standard | with AdventHealthHMOGold$2,00021525FL0010020

Gold SimpleHMOGold$3,00021525FL0020016

Gold Simple | with AdventHealthHMOGold$3,00021525FL0010023

Silver EliteHMOSilver$5,00021525FL0020008

Silver Elite | with AdventHealthHMOSilver$5,00021525FL0010012

Silver Simple PCP SaverHMOSilver$5,00021525FL0020012

Silver Simple PCP Saver | with AdventHealthHMOSilver$5,00021525FL0010016

Silver Simple Chronic Care CKMHMOSilver$5,90021525FL0020010

Silver Simple Chronic Care CKM | with AdventHealthHMOSilver$5,90021525FL0010014

Silver Classic StandardHMOSilver$6,00021525FL0020007

Silver Classic Standard | with AdventHealthHMOSilver$6,00021525FL0010010

Silver Simple Women's Health with Menopause BenefitsHMOSilver$6,00021525FL0020013

Silver Simple Breathe Easy with Enhanced COPD BenefitsHMOSilver$6,20021525FL0020009

Silver Simple DiabetesHMOSilver$6,50021525FL0020011

Silver Simple Diabetes | with AdventHealthHMOSilver$6,50021525FL0010015

Bronze Elite + PCP Saver PlusHMOExpanded Bronze$021525FL0020003

Bronze Elite + PCP Saver Plus | with AdventHealthHMOExpanded Bronze$021525FL0010005

Bronze Classic 4700HMOExpanded Bronze$4,70021525FL0020002

Bronze Classic 4700 | with AdventHealthHMOExpanded Bronze$4,70021525FL0010004

Bronze Simple Chronic Care CKMHMOExpanded Bronze$5,50021525FL0020005

Bronze Simple DiabetesHMOExpanded Bronze$5,50021525FL0020006

Bronze Classic StandardHMOExpanded Bronze$7,50021525FL0020001

Bronze Classic Standard | with AdventHealthHMOExpanded Bronze$7,50021525FL0010002

Bronze Simple Breathe Easy with Enhanced COPD BenefitsHMOExpanded Bronze$9,00021525FL0010006

Individual Florida HMO Broad network · 7 plans · Preferred tier

Gold Classic StandardHMOGold$2,00021525FL0010019

Silver Classic StandardHMOSilver$6,00021525FL0010009

Silver Simple Women's Health with Menopause BenefitsHMOSilver$6,00021525FL0010017

Silver Simple Breathe Easy with Enhanced COPD BenefitsHMOSilver$6,20021525FL0010013

Bronze Simple Chronic Care CKMHMOExpanded Bronze$5,50021525FL0010007

Bronze Simple DiabetesHMOExpanded Bronze$5,50021525FL0010008

Bronze Classic StandardHMOExpanded Bronze$7,50021525FL0010001

Molina Healthcare

22 plans · HMO

Accepting new patients

Molina Marketplace network · 19 plans · Preferred tier

Molina Gold Enhanced 895HMOGold$89554172FL0010012

Molina Gold Enhanced 895 Plus with Adult Dental and VisionHMOGold$89554172FL0070004

Molina Gold Enhanced 895 Plus with Adult VisionHMOGold$89554172FL0040004

Molina Gold Core 1640HMOGold$1,64054172FL0010001

Molina Gold Core 1640 Plus with Adult Dental and VisionHMOGold$1,64054172FL0070001

Molina Gold Core 1640 Plus with Adult VisionHMOGold$1,64054172FL0040001

Molina Gold StandardHMOGold$2,00054172FL0010008

Molina Silver CoreHMOSilver$6,00054172FL0010002

Molina Silver Core Plus with Adult Dental and VisionHMOSilver$6,00054172FL0070002

Molina Silver Core Plus with Adult VisionHMOSilver$6,00054172FL0040002

Molina Silver StandardHMOSilver$6,00054172FL0010009

Molina Silver Saver with Four Free PCP VisitsHMOSilver$7,00054172FL0010011

Molina Bronze Premier with $0 Medical DeductibleHMOExpanded Bronze$054172FL0010020

Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and VisionHMOExpanded Bronze$054172FL0070003

Molina Bronze Premier with $0 Medical Deductible Plus with Adult VisionHMOExpanded Bronze$054172FL0040012

Molina Bronze Enhanced 3500HMOExpanded Bronze$3,50054172FL0010013

Molina Bronze Enhanced 3500 Plus with Adult Dental and VisionHMOExpanded Bronze$3,50054172FL0070005

Molina Bronze Enhanced 3500 Plus with Adult VisionHMOExpanded Bronze$3,50054172FL0040005

Molina Bronze StandardHMOExpanded Bronze$7,50054172FL0010010

Molina Marketplace Tiered network · 3 plans · Preferred tier

Molina Silver AccessHMOSilver$5,75054172FL0060002

Molina Silver Access Plus with Adult Dental and VisionHMOSilver$5,75054172FL0090001

Molina Silver Access Plus with Adult VisionHMOSilver$5,75054172FL0080001

Ambetter Health

20 plans · HMO

Accepting new patients

Everyday GoldHMOGold$80049004FL0010010

Everyday Gold + Vision + Adult DentalHMOGold$80049004FL0020009

Complete GoldHMOGold$1,45049004FL0010011

Complete Gold + Vision + Adult DentalHMOGold$1,45049004FL0020010

Standard GoldHMOGold$2,00049004FL0010013

Standard Gold + Vision + Adult DentalHMOGold$2,00049004FL0020012

Enhanced Diabetes Care Silver with $0 Drug OptionsHMOSilver$5,00049004FL0010009

Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult DentalHMOSilver$5,00049004FL0020008

Standard SilverHMOSilver$6,00049004FL0010006

Standard Silver + Vision + Adult DentalHMOSilver$6,00049004FL0020027

Focused SilverHMOSilver$6,30049004FL0010007

Focused Silver + Vision + Adult DentalHMOSilver$6,30049004FL0020006

Clarity SilverHMOSilver$8,00049004FL0010031

Thrive SilverHMOSilver$8,00049004FL0010032

Elite BronzeHMOExpanded Bronze$049004FL0010004

Elite Bronze + Vision + Adult DentalHMOExpanded Bronze$049004FL0020004

Standard Expanded BronzeHMOExpanded Bronze$7,50049004FL0010001

Standard Expanded Bronze + Vision + Adult DentalHMOExpanded Bronze$7,50049004FL0020001

Everyday BronzeHMOExpanded Bronze$8,45049004FL0010002

Everyday Bronze + Vision + Adult DentalHMOExpanded Bronze$8,45049004FL0020002

AmeriHealth Caritas Next

8 plans · HMO

Accepting new patients

AmeriHealth Caritas Next Gold Premier + No ReferralsHMOGold$85067926FL0010009

AmeriHealth Caritas Next Gold Signature + No ReferralsHMOGold$2,00067926FL0010004

AmeriHealth Caritas Next Silver Premier + No ReferralsHMOSilver$40067926FL0010007

AmeriHealth Caritas Next Silver Signature + No ReferralsHMOSilver$6,00067926FL0010003

AmeriHealth Caritas Next Silver Essential + No ReferralsHMOSilver$6,10067926FL0010008

AmeriHealth Caritas Next Bronze Essential + No ReferralsHMOBronze$10,60067926FL0010001

AmeriHealth Caritas Next Bronze Premier + No ReferralsHMOExpanded Bronze$3,85067926FL0010006

AmeriHealth Caritas Next Bronze Signature + No ReferralsHMOExpanded Bronze$7,50067926FL0010002

Also listed in other states 84 plans · 4 states

Insurers sometimes list a provider in other states' networks, for example for telehealth or a practice near a state line. These plans are sold to residents of those states.

Oscar Health · Iowa

26 plans · EPO

Accepting new patientsDeductible $0 to $10,600

Individual Iowa network · 16 plans · Preferred tier

Gold Elite | MercyOneEPOGold$55045819IA0010036

Gold Classic Standard | MercyOneEPOGold$2,00045819IA0010053

Silver Classic | MercyOneEPOSilver$5,00045819IA0010006

Silver Simple PCP Saver | MercyOneEPOSilver$5,00045819IA0010025

Silver Simple Chronic Care CKM | MercyOneEPOSilver$5,90045819IA0010077

Silver Classic Standard | MercyOneEPOSilver$6,00045819IA0010052

Silver Simple Women's Health with Menopause Benefits | MercyOneEPOSilver$6,00045819IA0010078

Silver Simple Breathe Easy with Enhanced COPD Benefits | MercyOneEPOSilver$6,20045819IA0010076

Silver Simple Diabetes | MercyOneEPOSilver$6,50045819IA0010045

Bronze Elite + PCP Saver Plus | MercyOneEPOExpanded Bronze$045819IA0010005

Bronze Classic 4700 | MercyOneEPOExpanded Bronze$4,70045819IA0010024

Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOneEPOExpanded Bronze$5,50045819IA0010070

Bronze Simple Chronic Care CKM | MercyOneEPOExpanded Bronze$5,50045819IA0010071

Bronze Simple Diabetes | MercyOneEPOExpanded Bronze$5,50045819IA0010072

Bronze Classic Standard | MercyOneEPOExpanded Bronze$7,50045819IA0010050

Secure | MercyOneEPOCatastrophic$10,60045819IA0010011

Individual Iowa Broad network · 10 plans · Preferred tier

Gold EliteEPOGold$55045819IA0010063

Gold Classic StandardEPOGold$2,00045819IA0010067

Silver ClassicEPOSilver$5,00045819IA0010057

Silver Simple PCP SaverEPOSilver$5,00045819IA0010061

Silver Classic StandardEPOSilver$6,00045819IA0010066

Silver Simple DiabetesEPOSilver$6,50045819IA0010064

Bronze Elite + PCP Saver PlusEPOExpanded Bronze$045819IA0010056

Bronze Classic 4700EPOExpanded Bronze$4,70045819IA0010060

Bronze Classic StandardEPOExpanded Bronze$7,50045819IA0010065

SecureEPOCatastrophic$10,60045819IA0010058

Ambetter Health · Georgia

25 plans · HMO

Accepting new patientsDeductible $0 to $9,000

Elite Gold HMOHMOGold$070893GA0010074

Elite Gold HMO + Vision + Adult DentalHMOGold$070893GA0030075

Everyday Gold HMOHMOGold$80070893GA0010071

Everyday Gold HMO + Vision + Adult DentalHMOGold$80070893GA0030071

Clear Gold HMOHMOGold$1,20070893GA0010073

Clear Gold HMO + Vision + Adult DentalHMOGold$1,20070893GA0030074

Complete Gold HMOHMOGold$1,45070893GA0010020

Complete Gold HMO + Vision + Adult DentalHMOGold$1,45070893GA0030020

Standard Gold HMOHMOGold$2,00070893GA0010078

Standard Gold HMO + Vision + Adult DentalHMOGold$2,00070893GA0030078

Complete Silver HMOHMOSilver$5,95070893GA0010017

Complete Silver HMO + Vision + Adult DentalHMOSilver$5,95070893GA0030017

Standard Silver HMOHMOSilver$6,00070893GA0010077

Standard Silver HMO + Vision + Adult DentalHMOSilver$6,00070893GA0030077

Focused Silver HMOHMOSilver$6,30070893GA0010070

Focused Silver HMO + Vision + Adult DentalHMOSilver$6,30070893GA0030070

Clear Silver HMO with $0 Insulin OptionsHMOSilver$7,00070893GA0010068

Clear Bronze HMOHMOBronze$9,00070893GA0010006

Clear Bronze HMO + Vision + Adult DentalHMOBronze$9,00070893GA0030019

Choice Bronze HSA HMOHMOExpanded Bronze$7,25070893GA0010051

Choice Bronze HSA HMO + Vision + Adult DentalHMOExpanded Bronze$7,25070893GA0030051

Standard Expanded Bronze HMOHMOExpanded Bronze$7,50070893GA0010076

Standard Expanded Bronze HMO + Vision + Adult DentalHMOExpanded Bronze$7,50070893GA0030076

Everyday Bronze HMOHMOExpanded Bronze$8,45070893GA0010064

Everyday Bronze HMO + Vision + Adult DentalHMOExpanded Bronze$8,45070893GA0030064

Ambetter Health · Alabama

18 plans · EPO

Accepting new patientsDeductible $0 to $8,450

Elite GoldEPOGold$053932AL0100016

Elite Gold + Vision + Adult DentalEPOGold$053932AL0110015

Complete GoldEPOGold$1,45053932AL0100015

Complete Gold + Vision + Adult DentalEPOGold$1,45053932AL0110010

Standard GoldEPOGold$2,00053932AL0100013

Standard Gold + Vision + Adult DentalEPOGold$2,00053932AL0110013

Enhanced Diabetes Care Silver with $0 Drug OptionsEPOSilver$5,00053932AL0100018

Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult DentalEPOSilver$5,00053932AL0110018

Standard SilverEPOSilver$6,00053932AL0100012

Standard Silver + Vision + Adult DentalEPOSilver$6,00053932AL0110017

Focused SilverEPOSilver$6,30053932AL0100005

Focused Silver + Vision + Adult DentalEPOSilver$6,30053932AL0110005

Elite BronzeEPOExpanded Bronze$053932AL0100014

Elite Bronze + Vision + Adult DentalEPOExpanded Bronze$053932AL0110014

Standard Expanded BronzeEPOExpanded Bronze$7,50053932AL0100011

Standard Expanded Bronze + Vision + Adult DentalEPOExpanded Bronze$7,50053932AL0110011

Everyday BronzeEPOExpanded Bronze$8,45053932AL0100003

Everyday Bronze + Vision + Adult DentalEPOExpanded Bronze$8,45053932AL0110003

Oscar Health · Illinois

15 plans · HMO

Accepting new patientsDeductible $0 to $9,000

Individual Illinois Select network · 8 plans · Preferred tier

Gold Classic Standard (Select)HMOGold$2,00011574IL0020053

Gold Simple (Select)HMOGold$3,30011574IL0020059

Buena Salud Plateado 4360 (Select)HMOSilver$4,36011574IL0020057

Silver Classic Standard (Select)HMOSilver$6,00011574IL0020052

Silver Simple Diabetes (Select)HMOSilver$6,50011574IL0020060

Bronze Elite + PCP Saver Plus Rx (Select)HMOExpanded Bronze$011574IL0020055

Bronze Classic Standard (Select)HMOExpanded Bronze$7,50011574IL0020050

Bronze Simple (Select)HMOExpanded Bronze$9,00011574IL0020058

Individual Illinois Choice network · 7 plans · Preferred tier

Gold Classic Standard (Choice)HMOGold$2,00011574IL0010053

Gold Simple (Choice)HMOGold$3,30011574IL0010057

Silver Classic Standard (Choice)HMOSilver$6,00011574IL0010052

Silver Simple Diabetes (Choice)HMOSilver$6,50011574IL0010045

Bronze Elite + PCP Saver Plus Rx (Choice)HMOExpanded Bronze$011574IL0010055

Bronze Classic Standard (Choice)HMOExpanded Bronze$7,50011574IL0010050

Bronze Simple (Choice)HMOExpanded Bronze$9,00011574IL0010056

Questions about Dr. Cartaya’s insurance

What insurance does Dr. Cartaya take?

In Florida, Oscar Health, Molina Healthcare, Ambetter Health and AmeriHealth Caritas Next include Dr. Cartaya in 83 Marketplace plans for 2026. Call the office at (786) 715-9183 to confirm your plan before booking.

Is Dr. Cartaya accepting new patients?

The insurers that list Dr. Cartaya report that Dr. Cartaya is accepting new patients. Call the office at (786) 715-9183 to confirm your plan before booking.

Do I need a referral to see Dr. Cartaya?

Not under the Florida plans that list Dr. Cartaya: the 2026 plan files say a specialist referral is not required.

Does Dr. Cartaya accept Medicare?

Yes. CMS files show Dr. Cartaya accepts Medicare assignment and is enrolled in PECOS, which allows ordering and referring for Medicare patients.

About this data

This page combines public files from insurers and from CMS. NPI Profile does not contract with insurers and does not decide who is in network.

Source	What it provides here	Source date
Insurer provider directory files	Which plans list this provider, network tier, accepting new patients, years listed. Insurers selling on HealthCare.gov must publish these files under CMS rules.	AmeriHealth Caritas Next: Oct 15, 2026 Oscar Health: Oct 15, 2026 Ambetter Health: Oct 14, 2026 Molina Healthcare: Oct 10, 2026
CMS Health Insurance Exchange public use files	Plan details and Summary of Benefits links for HealthCare.gov states.	Plan year 2026
CMS state-based exchange public use files	Plan details for states that run their own exchange, here Georgia and Illinois. No document links.	Plan year 2026, Jun 3, 2026

Only Marketplace (ACA) plans are covered. Employer, Medicare Advantage and Medicaid managed care networks are not in these files.
Costs are for the standard version of each plan. People who qualify for cost-sharing reductions pay less on Silver plans.
Accepting new patients and network tier are reported by each insurer, and can differ from what the practice tells you.
Networks change during the year. Confirm with your insurer or the practice before booking.