DR. RAFE M HENG D.O., FACC
NPI 1477560126
Internal Medicine - Cardiovascular Disease in Maryville, IL
Active since August 02, 2006PECOS EnrolledAccepts Medicare Assignment
74.42/100
CMS Quality Rating
6812 STATE RTE 162 SUITE 202, MARYVILLE, IL 62062(618) 288-1748(618) 288-1768 Get Directions Write a Review
About Dr. Rafe M Heng D.o., Facc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RAFE M HENG D.O., FACC (NPI 1477560126) is an individual cardiovascular disease provider in Maryville, Illinois, licensed in Illinois (036113077) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Anderson Hospital, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (2002).
NPPES Registry Identity
NPI1477560126
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. RAFE M HENGCredential: D.O., FACC
Location Address6812 STATE RTE 162 SUITE 202Maryville, IL 62062
Mailing Address6812 State Rte 162 Suite 202Maryville, IL 62062 · (618) 288-1748 · Fax (618) 288-1768
Phone(618) 288-1748
Fax(618) 288-1768
Sole ProprietorYes
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2002
Enumeration DateAugust 2, 2006
Last NPPES UpdateJune 4, 2020
NPPES CertifiedJune 4, 2020
✔ NPI 1477560126 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in IL · 036113077
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.
6812 STATE RTE 162 SUITE 202, Maryville, IL 62062
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, 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. Rafe M Heng D.o., Facc 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 ID4082718325
PECOS Enrollment IDI20070327000370
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 18
Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
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.
583 services456 patients
Established patient office or other outpatient visit, 30-39 minutes 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.
571 services329 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.
467 services450 patients
Follow-up hospital inpatient care per day, typically 25 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.
113 services26 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018
An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
102 services101 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.
91 services80 patients
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Anderson Hospital
Acute Care Hospitals · Maryville, ILOwnershipVoluntary non-profit - Private
CMS Certification Number140289
Location6800 State Route 162Maryville, IL 62062 · Madison County
Emergency services Birthing friendly
Community Hospital Of Staunton
Critical Access Hospitals · Staunton, ILOwnershipVoluntary non-profit - Private
CMS Certification Number141306
Location400 N Caldwell StStaunton, IL 62088 · Macoupin County
Emergency services
St Francis Hospital
Critical Access Hospitals · Litchfield, ILOwnershipVoluntary non-profit - Church
CMS Certification Number141350
Location1215 Franciscan DrLitchfield, IL 62056 · Montgomery County
Emergency services Birthing friendly
Barnes Jewish Hospital
Acute Care Hospitals · Saint Louis, MOOwnershipVoluntary non-profit - Other
CMS Certification Number260032
LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62062 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
$131.14 typical visit price
range $56.28 – $173.35
Typical copayment $32.78 (range $14.07 – $43.33)
Most-billed visit code 99204
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
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.
74.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
70.31
Promoting Interoperability
85
Improvement Activities
40
Cost
56.92
Reported Quality Measures
Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
90%189 patients4/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
80%138 patients4/55-star benchmark: 99%
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.
99%1,661 patients4/55-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.
96%1,539 patients4/55-star benchmark: 100%
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.
99%489 patients4/55-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.
98%885 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
37%395 patients2/55-star benchmark: 90%
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…
69%874 patients3/55-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: 96% · 513 patients
Patients tobacco: 97% · 67 patients
96%513 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…
99%885 patients4/55-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…
11%885 patients1/55-star benchmark: 79%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
86%264 patients4/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 395 patients
0%395 patients5/55-star benchmark: 100%
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 11
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers23 claims23 services$71.77 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers21 claims49 services$27.91 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
3 suppliers14 claims75 services$15.97 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers23 claims23 services$46.04 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
7 suppliers30 claims30 services$14.89 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
5 suppliers38 claims38 services$9.45 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.
Internal Medicine (Critical Care Medicine)
6812 STATE RTE 162 SUITE 202
MARYVILLE, IL 62062
MARYVILLE, IL 62062
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477560126, enumerated as an "individual" on August 02, 2006.
The provider is located at 6812 STATE RTE 162 SUITE 202 MARYVILLE, IL 62062 and the phone number is (618) 288-1748.
Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health. Please consult your insurance carrier or call the provider to verify.
Rafe Heng is affiliated with: ANDERSON HOSPITAL, COMMUNITY HOSPITAL OF STAUNTON, ST FRANCIS HOSPITAL and BARNES JEWISH HOSPITAL.
