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HISHAM A ALREFAI MD
NPI 1811962350
Internal Medicine - Endocrinology, Diabetes & Metabolism in Louisville, KY

Active since February 20, 2006PECOS EnrolledAccepts Medicare Assignment
12.49/100
CMS Quality Rating
9720 PARK PLAZA AVE UNIT 104, LOUISVILLE, KY 40241(502) 895-8218(502) 895-8219 Get Directions Write a Review

NPPES record last updated: February 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 9, 2024, Oct 26, 2018 (2 updates tracked since 2018).

About Hisham A Alrefai Md NPPES

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

HISHAM A ALREFAI MD (NPI 1811962350) is an individual endocrinology, diabetes & metabolism provider in Louisville, Kentucky, licensed in Kentucky (37214) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Hardin, and maintains a secondary practice location in Elizabethtown.

NPPES Registry Identity

NPI1811962350
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameHISHAM A ALREFAICredential: MD
Location Address9720 PARK PLAZA AVE UNIT 104Louisville, KY 40241-2289
Mailing Address9720 Park Plaza Ave Unit 104Louisville, KY 40241-2289 · (502) 895-8218 · Fax (502) 895-8219
Phone(502) 895-8218
Fax(502) 895-8219
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateFebruary 20, 2006
Last NPPES UpdateFebruary 9, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2024
✔ NPI 1811962350 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in KY · 37214
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License 01055359A (IN)
9720 PARK PLAZA AVE UNIT 104, Louisville, KY 40241
Open in Google Maps ↗

Secondary Practice Location 1

Location 11230 Woodland Dr Ste 208Elizabethtown, KY 42701-2792 · Phone (502) 895-8218 · Fax (502) 895-8219

Other Identifiers 6

Other149327KY · Siho - Ncma
Other50053026MA · Passport - Ncma
Other000000831435KY · Anthem - Ncma
Medicaid200385521IN
Medicaid64055395KY
Other940540SSSSIN · Legacy Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health 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

Hisham A Alrefai 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 ID3173591609
PECOS Enrollment IDI20130821000479
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 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.
1,042 services532 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.
270 services183 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
73 services45 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 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.
60 services60 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.
52 services52 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Health Hardin

Acute Care Hospitals · Elizabethtown, KY
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number180012
Location913 North Dixie AvenueElizabethtown, KY 42701 · Hardin County
Emergency services

Owensboro Health Twin Lakes Medical Center

Acute Care Hospitals · Leitchfield, KY
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180070
Location910 Wallace AvenueLeitchfield, KY 42754 · Grayson County
Emergency services Birthing friendly

Taylor Regional Hospital

Acute Care Hospitals · Campbellsville, KY
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number180087
Location1700 Old Lebanon RoadCampbellsville, KY 42718 · Taylor County
Emergency services

Baptist Health Louisville

Acute Care Hospitals · Louisville, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180130
Location4000 Kresge WayLouisville, KY 40207 · Jefferson County
Emergency services Birthing friendly

Breckinridge Memorial Hospital

Critical Access Hospitals · Hardinsburg, KY
1/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number181319
Location1011 Old Highway 60Hardinsburg, KY 40143 · Breckinridge County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40241 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

12.49/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality0
Improvement Activities0
Cost41.65

Referred Medical Equipment & Supplies CMS DME claims 11

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
6 suppliers165 claims2,006 services$18.34 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
6 suppliers162 claims4,809 services$2.36 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
6 suppliers120 claims120 services$174.46 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
65 suppliers247 claims964 services$6.23 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers22 claims22 services$2.81 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
28 suppliers50 claims125 services$1.08 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 3

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

HISHAM A ALREFAI MD PSC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
9720 PARK PLAZA AVE UNIT 104
LOUISVILLE, KY 40241
Jefferson County (502) 895-8218
GUSOON MHESIN
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
9720 PARK PLAZA AVE UNIT 104
LOUISVILLE, KY 40241
Jefferson County (502) 895-8218
NICOLE KRISTINA DOZSA LCSW, LCADCA
Social Worker (Clinical)
9720 PARK PLAZA AVE UNIT 104
LOUISVILLE, KY 40241
Jefferson County (502) 938-0511

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 Hisham Alrefai's NPI number?

The NPI number for Hisham Alrefai is 1811962350. It was assigned to this individual provider in the NPPES registry on February 20, 2006.

Where is Hisham Alrefai located?

Hisham Alrefai practices at 9720 Park Plaza Ave Unit 104, Louisville, KY 40241. The listed phone number is (502) 895-8218.

What is Hisham Alrefai's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Hisham Alrefai enrolled in Medicare?

Yes. Hisham Alrefai 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 Hisham Alrefai accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Hisham Alrefai 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 Hisham Alrefai affiliated with any hospitals?

According to CMS data, Hisham Alrefai is affiliated with Baptist Health Hardin, Owensboro Health Twin Lakes Medical Center, Taylor Regional Hospital, Baptist Health Louisville and Breckinridge Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Hisham Alrefai was last updated on February 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.