HECTOR RAFAEL PICON MD
NPI 1457416869
Internal Medicine - Cardiovascular Disease in Rome, GA

Active since December 26, 2006PECOS EnrolledAccepts Medicare Assignment
77.45/100
CMS Quality Rating
504 REDMOND RD NW, ROME, GA 30165(706) 235-3855(706) 290-2382 Get Directions Write a Review

NPPES record last updated: July 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 10, 2025, Feb 4, 2019 (2 updates tracked since 2019).

About Hector Rafael Picon Md NPPES

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

HECTOR RAFAEL PICON MD (NPI 1457416869) is an individual cardiovascular disease provider in Rome, Georgia, licensed in Georgia (032022) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Floyd Medical Center, and is a graduate of Harvard Medical School (1982).

NPPES Registry Identity

NPI1457416869
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameHECTOR RAFAEL PICONCredential: MD
Location Address504 REDMOND RD NWRome, GA 30165-1416
Mailing Address221 Technology Pkwy NwRome, GA 30165-1369 · (762) 235-1000
Fax(706) 290-2382
Sole ProprietorNo
Medical School CMSHarvard Medical SchoolGraduated 1982
Enumeration DateDecember 26, 2006
Last NPPES UpdateJuly 10, 20252 updates tracked since enumeration
NPPES CertifiedJuly 10, 2025
NPI 1457416869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in GA · 032022
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X · License 032022 (GA)
504 REDMOND RD NW, Rome, GA 30165

Other Identifiers 2

Medicaid000489211AGA
Medicaid000489211JGA

Accepted 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

Hector Rafael Picon Md 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 ID1759312911
PECOS Enrollment IDI20060110000685, I20200608002515
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 45

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.
761 services528 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
682 services672 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
487 services330 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
430 services392 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
285 services244 patients
Blood test, clotting time 85610
A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
239 services24 patients

Hospital Affiliations CMS Care Compare 3

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

Atrium Health Floyd Medical Center

Acute Care Hospitals · Rome, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110054
Location304 Turner Mccall BoulevardRome, GA 30162 · Floyd County
Birthing friendly

Redmond Regional Medical Center

Acute Care Hospitals · Rome, GA
4/5 CMS rating
OwnershipProprietary
CMS Certification Number110168
Location501 Redmond Road NWRome, GA 30165 · Floyd County

Atrium Health Floyd Polk Medical Center

Critical Access Hospitals · Cedartown, GA
OwnershipVoluntary non-profit - Private
CMS Certification Number111330
Location2360 Rockmart HighwayCedartown, GA 30125 · Polk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30165 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
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.

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.

77.45/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality60.86
Promoting Interoperability100
Improvement Activities40
Cost63.96

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,359 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%3,674 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
29%125 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%262 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
84%1,915 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
84%1,921 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 375 patients
Patients tobacco: 29% · 21 patients
91%379 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,915 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
23%1,915 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
28%1,915 patients
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.

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.

Urology
504 REDMOND RD NW
ROME, GA 30165
Physician Assistant
504 REDMOND RD NW
ROME, GA 30165
Nurse Practitioner
504 REDMOND RD NW
ROME, GA 30165
Physician Assistant
504 REDMOND RD NW
ROME, GA 30165
Pediatrics (Pediatric Cardiology)
504 REDMOND RD NW
ROME, GA 30165
Nurse Practitioner
504 REDMOND RD NW
ROME, GA 30165
Nurse Practitioner (Family)
504 REDMOND RD NW
ROME, GA 30165
Urology
504 REDMOND RD NW
ROME, GA 30165

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 Hector Picon's NPI number?

The NPI number for Hector Picon is 1457416869. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Where is Hector Picon located?

Hector Picon practices at 504 Redmond Rd NW, Rome, GA 30165. The listed phone number is (706) 235-3855.

What is Hector Picon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Hector Picon enrolled in Medicare?

Yes. Hector Picon 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 Hector Picon accept?

Health plans from Alliant Health Plans, Inc. list Hector Picon 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 Hector Picon affiliated with any hospitals?

According to CMS data, Hector Picon is affiliated with Atrium Health Floyd Medical Center, Redmond Regional Medical Center and Atrium Health Floyd Polk Medical Center.

When was this NPI record last updated?

The NPPES record for Hector Picon was last updated on July 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.