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RAFAEL HECTOR VALDESPINO M.D.
NPI 1629248539
Internal Medicine in Hialeah, FL

Active since March 06, 2008PECOS EnrolledAccepts Medicare Assignment
93.74/100
CMS Quality Rating
777 E 25TH ST STE 419, HIALEAH, HIALEAH, FL 33013(305) 667-9519(786) 375-5397 Get Directions Write a Review

NPPES record last updated: April 29, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Rafael Hector Valdespino M.d. NPPES

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

RAFAEL HECTOR VALDESPINO M.D. (NPI 1629248539) is an individual internal medicine provider in Hialeah, Florida, licensed in Florida (ME 104195) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1629248539
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameRAFAEL HECTOR VALDESPINOCredential: M.D.
Location Address777 E 25TH ST STE 419, HIALEAHHialeah, FL 33013-3835
Mailing Address777 E 25th St Ste 419, HialeahHialeah, FL 33013-3835 · (305) 667-9519 · Fax (786) 375-5397
Phone(305) 667-9519
Fax(786) 375-5397
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateMarch 6, 2008
Last NPPES UpdateApril 29, 2015
✔ NPI 1629248539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in FL · ME 104195✔ Licensed in PR · 26460
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedEmergency MedicineTaxonomy 207P00000X · License ME 104195 (FL)
777 E 25TH ST STE 419, Hialeah, FL 33013
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Other Names 1

Other Name (5)Rafael Hector Valdespino Pairol M.d.

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), Oscar Health Maintenance Organization of Florida 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 Hector Valdespino 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 ID4587795364
PECOS Enrollment IDI20100622000734
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 5

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.
94 services31 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
59 services59 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
52 services51 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.
42 services23 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

Jackson Health System

Acute Care Hospitals · Miami, FL
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100022
Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33013 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
$141.56 typical visit price
range $60.92 – $187.05
Typical copayment $35.39 (range $15.23 – $46.76)
Most-billed visit code 99204
Established Patient
$107.17 typical visit price
range $18.99 – $150.24
Typical copayment $26.79 (range $4.74 – $37.56)
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.

93.74/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality83.53
Promoting Interoperability76
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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

Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each A4233
DME-Other DME · category DE017N
1 supplier16 claims32 services$0.45 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
1 supplier33 claims144 services$7.25 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
1 supplier33 claims33 services$2.95 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
1 supplier33 claims72 services$1.24 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.

MERCEDES GOMEZ APRN
Nurse Practitioner (Family)
777 E 25TH ST STE 419
HIALEAH, FL 33013
Miami-Dade County (305) 677-9519

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 Valdespino's NPI number?

The NPI number for Rafael Valdespino is 1629248539. It was assigned to this individual provider in the NPPES registry on March 6, 2008. The provider is also known as Rafael Hector Valdespino Pairol M.D..

Where is Rafael Valdespino located?

Rafael Valdespino practices at 777 E 25th St Ste 419 Hialeah, Hialeah, FL 33013. The listed phone number is (305) 667-9519.

What is Rafael Valdespino's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rafael Valdespino enrolled in Medicare?

Yes. Rafael Valdespino 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 Valdespino accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Rafael Valdespino 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 Valdespino affiliated with any hospitals?

According to CMS data, Rafael Valdespino is affiliated with Jackson Health System.

When was this NPI record last updated?

The NPPES record for Rafael Valdespino was last updated on April 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.