DR. ALI MEHMOOD RAUFI M.D.
NPI 1801088687
Internal Medicine in Sylvania, OH

Q: What is Ali Raufi's NPI number?

The NPI number for Ali Raufi is 1801088687. It was assigned to this individual provider in the NPPES registry on August 15, 2007.

Q: What is Ali Raufi's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ali Raufi was last updated on November 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since August 15, 2007PECOS EnrolledAccepts Medicare Assignment

5308 HARROUN RD STE 55, SYLVANIA, OH 43560(419) 824-6599(419) 882-3870 Get Directions Write a Review

NPPES record last updated: November 3, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 3, 2023, Aug 15, 2019 (2 updates tracked since 2019).

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About Dr. Ali Mehmood Raufi M.d. NPPES

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

DR. ALI MEHMOOD RAUFI M.D. (NPI 1801088687) is an individual internal medicine provider in Sylvania, Ohio, licensed in Ohio (35130578) and active in the NPI registry since August 2007. He is enrolled in Medicare PECOS, is affiliated with Promedica Charles And Virginia Hickman Hospital, and maintains a secondary practice location in Detroit.

NPPES Registry Identity

NPI1801088687

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. ALI MEHMOOD RAUFICredential: M.D.

Location Address5308 HARROUN RD STE 55Sylvania, OH 43560-2174

Mailing Address317 Shadywood RdRochester Hills, MI 48307-5054 · (248) 299-2983

Phone(419) 824-6599

Fax(419) 882-3870

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateAugust 15, 2007

Last NPPES UpdateNovember 3, 20232 updates tracked since enumeration

✔ NPI 1801088687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in OH · 35130578✔ Licensed in MI · 4301089401

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.

5308 HARROUN RD STE 55, Sylvania, OH 43560

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Secondary Practice Location 1

Location 14201 Saint Antoine St, 2E UHCDetroit, MI 48201-2153 · Phone (313) 745-4984

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ali Mehmood Raufi 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 ID1153519079

PECOS Enrollment IDI20101220000571, I20170811003097

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.

Medicare Billing Reassignments

Medicare enrollment records show Ali Raufi reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Promedica Central Physicians

9.2 mi

Family Medicine

100 MADISON AVE, MSC-S38805
Toledo, OH 43604

Reassigned Medicare billing, Ohio enrollment
1,072 clinicians in this Medicare group

NPI 1043270150 (567) 585-1964

Promedica Multi Specialty Physicians

9.2 mi

Family Medicine

100 MADISON AVE, MSC-S38805
Toledo, OH 43604

Reassigned Medicare billing, Michigan and Ohio enrollments
83 clinicians in this Medicare group

NPI 1306105150 (567) 585-1964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 14

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.

298 services117 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

271 services139 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

215 services54 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

143 services49 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.

79 services68 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

53 services42 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 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.

53 services33 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 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.

35 services34 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

31 services31 patients

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.

31 services30 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 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.

25 services14 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

20 services20 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

18 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 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.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

Promedica Charles And Virginia Hickman Hospital

Acute Care Hospitals · Adrian, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230005

Location5640 N Adrian HighwayAdrian, MI 49221 · Lenawee County

Emergency services Birthing friendly

Promedica Toledo Hospital

Acute Care Hospitals · Toledo, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360068

Location2142 North Cove BoulevardToledo, OH 43606 · Lucas County

Emergency services Birthing friendly

Bay Park Community Hospital

Acute Care Hospitals · Oregon, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360259

Location2801 Bay Park DriveOregon, OH 43616 · Lucas County

Emergency services Birthing friendly

Henry County Hospital, Inc

Critical Access Hospitals · Napoleon, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361309

Location1600 East Riverview AvenueNapoleon, OH 43545 · Henry County

Emergency services

Promedica Defiance Regional Hospital

Critical Access Hospitals · Defiance, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361328

Location1200 Ralston AvenueDefiance, OH 43512 · Defiance County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43560 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

Other Providers at the Same Location NPPES 11

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

QUNFANG LI MD

Internal Medicine (Hematology & Oncology)