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RAFAEL ELLIOT VALENZUELA-TAPIA D.O, M.D
NPI 1871952515
Internal Medicine - Nephrology in Delray Beach, FL

Active since February 22, 2016PECOS EnrolledAccepts Medicare Assignment
88.2/100
CMS Quality Rating
5210 LINTON BLVD STE 105, DELRAY BEACH, FL 33484(561) 496-1160(561) 496-2660 Get Directions Write a Review

NPPES record last updated: May 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 30, 2021, Mar 24, 2019, Jun 13, 2016 and 1 more (4 updates tracked since 2016).

About Rafael Elliot Valenzuela-tapia D.o, M.d NPPES

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

RAFAEL ELLIOT VALENZUELA-TAPIA D.O, M.D (NPI 1871952515) is an individual nephrology provider in Delray Beach, Florida, licensed in Florida (OS15718) and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2016).

NPPES Registry Identity

NPI1871952515
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameRAFAEL ELLIOT VALENZUELA-TAPIACredential: D.O, M.D
Location Address5210 LINTON BLVD STE 105Delray Beach, FL 33484-6537
Mailing Address6349 Las Flores DrBoca Raton, FL 33433-2362 · (516) 439-0316
Phone(561) 496-1160
Fax(561) 496-2660
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2016
Enumeration DateFebruary 22, 2016
Last NPPES UpdateMay 30, 20214 updates tracked since enumeration
NPPES CertifiedMay 30, 2021
✔ NPI 1871952515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in FL · OS15718
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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License OS15718 (FL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
5210 LINTON BLVD STE 105, Delray Beach, FL 33484
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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 Elliot Valenzuela-tapia D.o, 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 ID8426357088
PECOS Enrollment IDI20160503001165
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 8

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.

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.
1,232 services215 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.
203 services167 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.
104 services58 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.
99 services20 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.
49 services26 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.
27 services24 patients

Hospital Affiliations CMS Care Compare 2

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

Hca Florida Aventura Hospital

Acute Care Hospitals · Aventura, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100131
Location20900 Biscayne BlvdAventura, FL 33180 · Miami-Dade County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33484 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
$135.56 typical visit price
range $58.56 – $179.05
Typical copayment $33.89 (range $14.64 – $44.76)
Most-billed visit code 99204
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
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.

88.2/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality91.81
Promoting Interoperability96
Improvement Activities40
Cost55.53

Reported Quality Measures

Breast Cancer Screening
5%22 patients1/55-star benchmark: 93%
Closing the Referral Loop: Receipt of Specialist Report
35%26 patients2/55-star benchmark: 87%
Controlling High Blood Pressure
75%65 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
0%30 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
33%30 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
29%1,204 patients1/55-star benchmark: 100%
e-Prescribing
95%494 patients3/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
0%131 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
41%165 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
0%165 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
26%315 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 0% · 125 patients
0%125 patients
Provide Patients Electronic Access to Their Health Information
66%88 patients3/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
87%54 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 134 patients
Patients totalRate: 0% · 134 patients
0%134 patients5/55-star benchmark: 100%
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.

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 Valenzuela-tapia's NPI number?

The NPI number for Rafael Valenzuela-tapia is 1871952515. It was assigned to this individual provider in the NPPES registry on February 22, 2016.

Where is Rafael Valenzuela-tapia located?

Rafael Valenzuela-tapia practices at 5210 Linton Blvd Ste 105, Delray Beach, FL 33484. The listed phone number is (561) 496-1160.

What is Rafael Valenzuela-tapia's specialty?

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

Is Rafael Valenzuela-tapia enrolled in Medicare?

Yes. Rafael Valenzuela-tapia 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 Valenzuela-tapia accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 2 other insurers list Rafael Valenzuela-tapia 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 Valenzuela-tapia affiliated with any hospitals?

According to CMS data, Rafael Valenzuela-tapia is affiliated with Jackson Health System and Hca Florida Aventura Hospital.

When was this NPI record last updated?

The NPPES record for Rafael Valenzuela-tapia was last updated on May 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.