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RAFAEL JIMENEZ MD
NPI 1568493443
Internal Medicine - Cardiovascular Disease in Kissimmee, FL

Active since July 06, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
302 W BASS ST, KISSIMMEE, FL 34741(407) 518-7999(407) 518-9766 Get Directions Write a Review

NPPES record last updated: April 23, 2014. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Rafael Jimenez Md NPPES

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

RAFAEL JIMENEZ MD (NPI 1568493443) is an individual cardiovascular disease provider in Kissimmee, Florida, licensed in Florida (ME0059612) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Orlando, and is a graduate of University Central Del Caribe Escuela De Medicina (1986).

NPPES Registry Identity

NPI1568493443
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameRAFAEL JIMENEZCredential: MD
Location Address302 W BASS STKissimmee, FL 34741-5001
Mailing Address302 W Bass StKissimmee, FL 34741-5001 · (407) 518-7999 · Fax (407) 518-9766
Phone(407) 518-7999
Fax(407) 518-9766
Sole ProprietorNo
Medical School CMSUniversity Central Del Caribe Escuela De MedicinaGraduated 1986
Enumeration DateJuly 6, 2006
Last NPPES UpdateApril 23, 2014
✔ NPI 1568493443 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 FL · ME0059612
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.
302 W BASS ST, Kissimmee, FL 34741
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Other Identifiers 9

Other10411101FL · Citrus Care
Other4380411FL · Aetna
Medicare UPINE95696
Medicare ID-Type Unspecified12488FL
Other06920FL · Wellcare
Medicaid251215700FL
Medicare ID-Type Unspecified40739FL
Other2102311Ghi
Other4724188FL · Cigna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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 Jimenez 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 ID1153212048
PECOS Enrollment IDI20040322000651
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 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.
348 services187 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.
144 services135 patients
Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
64 services16 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.
53 services52 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.
25 services20 patients
Heart rhythm recording of continous external ekg over 8-15 days 93246
A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.
24 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Adventhealth Orlando

Acute Care Hospitals · Orlando, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100007
Location601 E Rollins StOrlando, FL 32803 · Orange County
Emergency services Birthing friendly

Hca Florida Osceola Hospital

Acute Care Hospitals · Kissimmee, FL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number100110
Location700 West Oak StreetKissimmee, FL 34741 · Osceola County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34741 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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%3,646 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.
98%1,402 patients4/55-star benchmark: 100%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
93%612 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.
95%770 patients4/55-star benchmark: 100%
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…
99%2,293 patients4/55-star benchmark: 100%
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
53%38 patients3/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
78%1,092 patients4/55-star benchmark: 100%
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…
98%770 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…
42%770 patients3/55-star benchmark: 79%
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 2

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

MAGDA E. SANCHEZ-VELEZ, M.D., P.A.
Internal Medicine (Cardiovascular Disease)
302 W BASS ST
KISSIMMEE, FL 34741
Osceola County (407) 518-7999
MAGDA ENID SANCHEZ-VELEZ M.D.
Internal Medicine (Cardiovascular Disease)
302 W BASS ST
KISSIMMEE, FL 34741
Osceola County (407) 518-7999

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 Jimenez's NPI number?

The NPI number for Rafael Jimenez is 1568493443. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Rafael Jimenez located?

Rafael Jimenez practices at 302 W Bass St, Kissimmee, FL 34741. The listed phone number is (407) 518-7999.

What is Rafael Jimenez's specialty?

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

Is Rafael Jimenez enrolled in Medicare?

Yes. Rafael Jimenez 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 Jimenez accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Rafael Jimenez 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 Jimenez affiliated with any hospitals?

According to CMS data, Rafael Jimenez is affiliated with Adventhealth Orlando and Hca Florida Osceola Hospital.

When was this NPI record last updated?

The NPPES record for Rafael Jimenez was last updated on April 23, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.