DR. RAFAEL A CORTES MD
NPI 1770729816
Internal Medicine - Gastroenterology in St Augustine, FL

Q: What is Rafael Cortes's NPI number?

The NPI number for Rafael Cortes is 1770729816. It was assigned to this individual provider in the NPPES registry on December 19, 2008.

Q: What is Rafael Cortes's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Rafael Cortes was last updated on June 11, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 19, 2008PECOS EnrolledAccepts Medicare Assignment

77.15/100

CMS Quality Rating

100 WHETSTONE PL, SUITE 105, ST AUGUSTINE, FL 32086(904) 829-9557(904) 829-9125 Get Directions Write a Review

NPPES record last updated: June 11, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Dr. Rafael A Cortes Md NPPES

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

DR. RAFAEL A CORTES MD (NPI 1770729816) is an individual gastroenterology provider in St Augustine, Florida, licensed in Florida (ME90959) and active in the NPI registry since December 2008. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of University Central Del Caribe Escuela De Medicina (2004).

NPPES Registry Identity

NPI1770729816

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. RAFAEL A CORTESCredential: MD

Location Address100 WHETSTONE PL, SUITE 105St Augustine, FL 32086-5774

Mailing Address4800 Belfort RdJacksonville, FL 32256-6004 · (904) 398-7205

Phone(904) 829-9557

Fax(904) 829-9125

Sole ProprietorNo

Medical School CMSUniversity Central Del Caribe Escuela De MedicinaGraduated 2004

Enumeration DateDecember 19, 2008

Last NPPES UpdateJune 11, 2015

✔ NPI 1770729816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in FL · ME90959

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

100 WHETSTONE PL, St Augustine, FL 32086

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Other Identifiers 3

Medicaid001047300FL

Medicare PINCG702YFL

Other003159216AGA · Georgia Medicaid

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) 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

Dr. Rafael A Cortes 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 ID244376952

PECOS Enrollment IDI20091012000078

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 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, 20-29 minutes 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.

285 services221 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.

158 services136 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

130 services125 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

114 services113 patients

New patient office or other outpatient visit, 45-59 minutes 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

104 services104 patients

Follow-up hospital inpatient care per day, typically 35 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

102 services51 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.

93 services48 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

68 services68 patients

Initial hospital inpatient care per day, typically 50 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.

60 services58 patients

New patient office or other outpatient visit, 30-44 minutes 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

32 services32 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

31 services29 patients

New patient office or other outpatient visit, 15-29 minutes 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

25 services25 patients

Initial hospital inpatient care per day, typically 70 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

22 services22 patients

Established patient office or other outpatient visit, 10-19 minutes 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

16 services16 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

15 services15 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

14 services14 patients

Upper gastrointestinal (GI) endoscopy for acid reflux NAN12

An upper GI endoscopy is a procedure to examine your esophagus and stomach using a thin, flexible tube called an endoscope. It helps diagnose conditions like acid reflux by identifying any inflammation or damage. It's generally safe, performed under sedation, and takes about 15-30 minutes.

0 services263 patients

Colonoscopy NAN13

A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.

0 services258 patients

Hospital Affiliations CMS Care Compare 2

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Flagler Hospital

Acute Care Hospitals · Saint Augustine, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100090

Location400 Health Park BlvdSaint Augustine, FL 32086 · St. Johns County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32086 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

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

77.15/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

65.95

Promoting Interoperability

Improvement Activities

Cost

61.22

Reported Quality Measures

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

42%50 patients2/55-star benchmark: 95%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

71%970 patients4/55-star benchmark: 85%

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.

95%2,420 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.

94%1,865 patients4/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

89%56 patients4/55-star benchmark: 98%

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.

97%1,205 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.

69%1,686 patients3/55-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

4%497 patients1/55-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…

17%1,529 patients1/55-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: 23% · 729 patients

20%729 patients1/55-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…

96%1,686 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…

19%1,686 patients1/55-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 20

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

FIRST COAST GASTROENTEROLOGY

Internal Medicine (Gastroenterology)

100 WHETSTONE PL, SUITE 105
ST AUGUSTINE, FL 32086

St. Johns County (904) 829-9557

DR. DAVID B TUCHINSKY DC

Chiropractor

100 WHETSTONE PL, SUITE 310
ST AUGUSTINE, FL 32086

St. Johns County (904) 217-7450

DR. WILLIAM FRANCIS FOODY JR. M.D.

Internal Medicine (Gastroenterology)

100 WHETSTONE PL, STE 105
ST AUGUSTINE, FL 32086

St. Johns County (904) 829-9557

DR. RAMZI M SHAQAREQ MD

Internal Medicine (Pulmonary Disease)

100 WHETSTONE PL, SUITE 208
ST AUGUSTINE, FL 32086

St. Johns County (904) 819-6800

MR. RANDALL T MATHIS PA-C

Physician Assistant (Surgical)

100 WHETSTONE PL, STE 310
ST AUGUSTINE, FL 32086

St. Johns County (904) 217-7450

DAVID LANCE GREENWALD M.D.

Neurological Surgery

100 WHETSTONE PL, STE 310
ST AUGUSTINE, FL 32086

St. Johns County (904) 217-7450

FIRST COAST PULMONARY ASSOCIATES

Internal Medicine (Pulmonary Disease)

100 WHETSTONE PL, SUITE 208
ST AUGUSTINE, FL 32086

St. Johns County (904) 819-6800

INFECTIOUS DISEASES ASSOCIATES OF NORTH FLORIDA, P.A.

Legal Medicine

100 WHETSTONE PL, SUITE 205
ST AUGUSTINE, FL 32086

St. Johns County (904) 819-9925

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 Cortes's NPI number?

The NPI number for Rafael Cortes is 1770729816. It was assigned to this individual provider in the NPPES registry on December 19, 2008.

Where is Rafael Cortes located?

Rafael Cortes practices at 100 Whetstone Pl Suite 105, St Augustine, FL 32086. The listed phone number is (904) 829-9557.

What is Rafael Cortes's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Rafael Cortes enrolled in Medicare?

Yes. Rafael Cortes 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 Cortes accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Florida Health Care Plans and 2 other insurers list Rafael Cortes 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 Cortes affiliated with any hospitals?

According to CMS data, Rafael Cortes is affiliated with Baptist Health Medical Center - Jacksonville and Flagler Hospital.

When was this NPI record last updated?

The NPPES record for Rafael Cortes was last updated on June 11, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.