RAFAEL O DUCHESNE M.D.
NPI 1588657332
Internal Medicine - Nephrology in Dalton, GA

Active since August 26, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1506 BROADRICK DR, DALTON, GA 30720(706) 278-3430(706) 279-1327 Get Directions Write a Review

NPPES record last updated: February 21, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Rafael O Duchesne M.d. NPPES

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

RAFAEL O DUCHESNE M.D. (NPI 1588657332) is an individual nephrology provider in Dalton, Georgia, licensed in Georgia (041424) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Hamilton Medical Center, and is a graduate of Emory University School Of Medicine (1995).

NPPES Registry Identity

NPI1588657332
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameRAFAEL O DUCHESNECredential: M.D.
Location Address1506 BROADRICK DRDalton, GA 30720-3011
Mailing Address1506 Broadrick DrDalton, GA 30720-3011 · (706) 278-3430 · Fax (706) 279-1327
Fax(706) 279-1327
Sole ProprietorNo
Medical School CMSEmory University School Of MedicineGraduated 1995
Enumeration DateAugust 26, 2005
Last NPPES UpdateFebruary 21, 2017
NPI 1588657332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in GA · 041424
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1506 BROADRICK DR, Dalton, GA 30720

Other Identifiers 3

Medicare UPINH14391GA
Medicaid00867061AGA
Medicare ID-Type Unspecified11BDRSCGA

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

Rafael O Duchesne 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 ID4688857998
PECOS Enrollment IDI20110324000167
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 29

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.

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.
430 services244 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
358 services242 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
343 services103 patients
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.
325 services227 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
286 services206 patients
Kidney function blood test panel 80069
A kidney function blood test panel checks how well your kidneys are working. It measures levels of various substances in your blood, including proteins, electrolytes, and waste products. The results can help detect potential kidney issues early.
211 services157 patients

Hospital Affiliations CMS Care Compare 2

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

Hamilton Medical Center

Acute Care Hospitals · Dalton, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110001
Location1200 Memorial DriveDalton, GA 30720 · Whitfield County
Birthing friendly

Adventhealth Murray

Acute Care Hospitals · Chatsworth, GA
OwnershipVoluntary non-profit - Private
CMS Certification Number110050
Location707 Old Dalton Ellijay Road, PO Box 1406Chatsworth, GA 30705 · Murray County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30720 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
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

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

Reported Quality Measures

Clinical Information Reconciliation
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician performs clinical information reconciliation.
48%128 patients2/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
47%43 patients2/55-star benchmark: 95%
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.
88%2,726 patients3/55-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%693 patients4/55-star benchmark: 100%
Patient-Generated Health Data
Patient-generated health data or data from a non-clinical setting is incorporated into the certified EHR technology for at least one unique patient seen by the MIPS eligible clinician during the performance period.
4%464 patients
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…
97%464 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
44%381 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…
98%662 patients5/55-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: 91% · 300 patients
Patients tobacco: 90% · 300 patients
88%26 patients4/55-star benchmark: 98%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
96%464 patients4/55-star benchmark: 100%
Request/Accept Summary of Care
For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient's record an…
1%119 patients1/55-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 certified EHR technology to the patient (or the patient-authorized representative), or in…
2%464 patients1/55-star benchmark: 75%
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% · 381 patients
0%381 patients5/55-star benchmark: 100%
View, Download and Transmit (VDT)
During the performance period, at least one unique patient (or patient-authorized representatives) seen by the MIPS eligible clinician actively engages with the EHR made accessible by the MIPS eligible clinician.
2%464 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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$46.13 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers11 claims1,300 services$0.19 avg. paid by Medicare
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823
DME-Wheelchairs · category DD009N
1 supplier11 claims11 services$119.85 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers16 claims16 services$18.87 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
3 suppliers18 claims18 services$12.58 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 9

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

Internal Medicine (Nephrology)
1506 BROADRICK DR
DALTON, GA 30720
Internal Medicine (Nephrology)
1506 BROADRICK DR
DALTON, GA 30720
Nurse Practitioner
1506 BROADRICK DR
DALTON, GA 30720
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
1506 BROADRICK DR, SUITE 1
DALTON, GA 30720
Nurse Practitioner (Adult Health)
1506 BROADRICK DR
DALTON, GA 30720
Internal Medicine (Nephrology)
1506 BROADRICK DR
DALTON, GA 30720
Internal Medicine (Nephrology)
1506 BROADRICK DR
DALTON, GA 30720
Internal Medicine (Nephrology)
1506 BROADRICK DR
DALTON, GA 30720

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 Duchesne's NPI number?

The NPI number for Rafael Duchesne is 1588657332. It was assigned to this individual provider in the NPPES registry on August 26, 2005.

Where is Rafael Duchesne located?

Rafael Duchesne practices at 1506 Broadrick Dr, Dalton, GA 30720. The listed phone number is (706) 278-3430.

What is Rafael Duchesne's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Rafael Duchesne enrolled in Medicare?

Yes. Rafael Duchesne 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 Duchesne accept?

Health plans from Alliant Health Plans, Inc. list Rafael Duchesne 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 Duchesne affiliated with any hospitals?

According to CMS data, Rafael Duchesne is affiliated with Hamilton Medical Center and Adventhealth Murray.

When was this NPI record last updated?

The NPPES record for Rafael Duchesne was last updated on February 21, 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.