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RAFAEL SANTANA M.D.
NPI 1497786115
Hospitalist in Atlanta, GA

Active since July 05, 2006PECOS EnrolledAccepts Medicare Assignment
98.31/100
CMS Quality Rating
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342(404) 851-8000(404) 851-6325 Get Directions Write a Review

NPPES record last updated: January 18, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rafael Santana M.d. NPPES

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

RAFAEL SANTANA M.D. (NPI 1497786115) is an individual hospitalist provider in Atlanta, Georgia, licensed in Georgia (039931) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1497786115
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameRAFAEL SANTANACredential: M.D.
Location Address1000 JOHNSON FERRY RD NEAtlanta, GA 30342-1606
Mailing Address1000 Johnson Ferry Rd NeAtlanta, GA 30342-1606 · (404) 851-8000 · Fax (404) 851-6325
Phone(404) 851-8000
Fax(404) 851-6325
Sole ProprietorYes
Medical School CMSOtherGraduated 1983
Enumeration DateJuly 5, 2006
Last NPPES UpdateJanuary 18, 2017
✔ NPI 1497786115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in GA · 039931
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 039931 (GA)
1000 JOHNSON FERRY RD NE, Atlanta, GA 30342
Open in Google Maps ↗

Other Identifiers 3

Medicaid000663737AGA
Medicare UPINF75197GA
Medicare PIN11SCHPJGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama 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

Rafael Santana 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 ID2860583119
PECOS Enrollment IDI20070801000342
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

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
221 services212 patients

Hospital Affiliations CMS Care Compare

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

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30342 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

98.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality97.88
Improvement Activities40
Cost84.56

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.

HANNAH L STEELE CRNA
Nurse Anesthetist, Certified Registered
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (770) 645-9181
VALERIE S WEBB NP
Nurse Practitioner (Women's Health)
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (770) 645-9181
AMAR R HERNDON
Anesthesiologist Assistant
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (770) 645-9181
MISHANA L. MOGELNICKI PAAA
Anesthesiologist Assistant
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (770) 645-9181
SUSAN C. OSGOOD CRNA
Nurse Anesthetist, Certified Registered
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (770) 645-9181
MRS. KIMBERLY CHILDRES WILLIAMS RPH
Pharmacist
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (404) 851-8123
MS. PATRICIA BOATRIGHT GILLEY RPH
Pharmacist
1000 JOHNSON FERRY RD NE, NORTHSIDE HOSPITAL PHARMACY
ATLANTA, GA 30342
Fulton County (404) 851-8908
AMY J FIGUEROA MD
Radiology (Diagnostic Radiology)
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342
Fulton County (404) 851-8000

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 Rafael Santana's NPI number?

The NPI number for Rafael Santana is 1497786115. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Where is Rafael Santana located?

Rafael Santana practices at 1000 Johnson Ferry Rd NE, Atlanta, GA 30342. The listed phone number is (404) 851-8000.

What is Rafael Santana's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Rafael Santana enrolled in Medicare?

Yes. Rafael Santana 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 Rafael Santana accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Rafael Santana 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 Rafael Santana affiliated with any hospitals?

According to CMS data, Rafael Santana is affiliated with Northside Hospital.

When was this NPI record last updated?

The NPPES record for Rafael Santana was last updated on January 18, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.