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KAMRAN RAFIQ M.D.
NPI 1942395546
Internal Medicine in Paulding, OH

Active since October 03, 2006PECOS EnrolledAccepts Medicare Assignment
1035 W WAYNE ST, PAULDING, OH 45879(419) 399-4080(419) 399-3688 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 15, 2025, Feb 10, 2025, Nov 5, 2024 (3 updates tracked since 2024).

About Kamran Rafiq M.d. NPPES

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

KAMRAN RAFIQ M.D. (NPI 1942395546) is an individual internal medicine provider in Paulding, Ohio, licensed in Ohio (35.084518) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Lawrence County Memorial Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1942395546
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKAMRAN RAFIQCredential: M.D.
Location Address1035 W WAYNE STPaulding, OH 45879-1544
Mailing Address5800 Monroe St., Bldg E #4Sylvania, OH 43560
Phone(419) 399-4080
Fax(419) 399-3688
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateOctober 3, 2006
Last NPPES UpdateSeptember 15, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2025
✔ NPI 1942395546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OH · 35.084518
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 35.084518 (OH), 036.167407 (IL)
1035 W WAYNE ST, Paulding, OH 45879
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1200 E Fairman AveWatseka, IL 60970-1644 · Phone (815) 432-7762
Location 2433 W. High St.Bryan, OH 43506 · Phone (419) 824-5063 ext. 107

Other Identifiers 2

Other000000335437Anthem
Medicaid2491594OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Wellmark Health Plan of Iowa, Inc..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

Kamran Rafiq 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 ID7517945009
PECOS Enrollment IDI20040712000207, I20240410003659
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

6

Medicare enrollment records show Kamran Rafiq reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Paulding County Hospital Physician Services
Same address
Family Medicine
1032 W. WAYNE ST
Paulding, OH 45879
  • Reassigned Medicare billing, Ohio enrollment
  • 35 clinicians in this Medicare group
NPI 1891744843 (419) 399-1104
Noes/Paulding, Ltd
62 mi
Emergency Medicine
5800 MONROE ST, BUILDING E #4
Sylvania, OH 43560
  • Reassigned Medicare billing, Ohio enrollment
  • 11 clinicians in this Medicare group
NPI 1619997459 (419) 824-3433
Iroquois Memorial Hospital And Resident Home
163 mi
General Practice
135 W STATION ST
Saint Anne, IL 60964
  • Reassigned Medicare billing, Illinois enrollment
  • Also billed through NPI 1629003470 (Illinois)
  • 78 clinicians in this Medicare group
NPI 1215650528 (815) 432-5841
Illinois Emergency Medicine Specialists, LLC
185 mi
Emergency Medical Services
500 REMINGTON BLVD
Bolingbrook, IL 60440
  • Reassigned Medicare billing, Illinois enrollment
  • 187 clinicians in this Medicare group
NPI 1003150962 (630) 312-5000
Lawrence County Memorial Hospital
234 mi
Critical Access
2200 STATE ST
Lawrenceville, IL 62439
  • Reassigned Medicare billing, Illinois enrollment
  • Also billed through NPI 1396024162 (Illinois)
  • 80 clinicians in this Medicare group
NPI 1881643401 (618) 943-1000
Statera Health Care, LLC
317 mi
Emergency Medicine
100 DR WARREN TUTTLE DR
Harrisburg, IL 62946
  • Reassigned Medicare billing, Illinois enrollment
  • 169 clinicians in this Medicare group
NPI 1043874449 (618) 833-1691

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 4

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.

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.
171 services147 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.
61 services53 patients
Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
24 services23 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.
19 services18 patients

Hospital Affiliations CMS Care Compare 4

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

Lawrence County Memorial Hospital

Critical Access Hospitals · Lawrenceville, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141344
Location2200 State StLawrenceville, IL 62439 · Lawrence County
Emergency services

Iroquois Memorial Hospital

Critical Access Hospitals · Watseka, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141353
Location200 Fairman StreetWatseka, IL 60970 · Iroquois County
Emergency services

Paulding County Hospital

Critical Access Hospitals · Paulding, OH
OwnershipGovernment - Local
CMS Certification Number361300
Location1035 West Wayne St.Paulding, OH 45879 · Paulding 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 45879 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.

Referred Medical Equipment & Supplies CMS DME claims

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

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier12 claims12 services$7.37 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 11

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

MELANIE BANKS FNP-C
Nurse Practitioner (Family)
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (419) 399-4080
PAULDING COUNTY HOSPITAL
General Acute Care Hospital (Critical Access)
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (419) 399-4080
BARBARA HOERSTEN RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (419) 399-4080
KARLA TURNWALD RPH
Pharmacist
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (419) 339-1152
MIDWEST FOOT AND ANKLE CLINIC LLC
Durable Medical Equipment & Medical Supplies
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (419) 799-1180
JACOB SHAFFER APRN, FNP-BC
Nurse Practitioner (Family)
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (800) 741-1743
DR. SIDDHARTHA PATRICK DASH MD
Student in an Organized Health Care Education/Training Program
1035 W WAYNE ST
PAULDING, OH 45879
Paulding County (419) 399-4080
KIMBERLY KAY MOLITOR AU.D.
Audiologist
1035 W WAYNE ST, SUITE 10
PAULDING, OH 45879
Paulding County (419) 399-1135

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 Kamran Rafiq's NPI number?

The NPI number for Kamran Rafiq is 1942395546. It was assigned to this individual provider in the NPPES registry on October 3, 2006.

Where is Kamran Rafiq located?

Kamran Rafiq practices at 1035 W Wayne St, Paulding, OH 45879. The listed phone number is (419) 399-4080.

What is Kamran Rafiq's specialty?

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

Is Kamran Rafiq enrolled in Medicare?

Yes. Kamran Rafiq 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.

Which organizations bill Medicare for Kamran Rafiq's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kamran Rafiq reassigns Medicare benefits to 6 organizations: Paulding County Hospital Physician Services (Paulding, OH), Noes/Paulding, Ltd (Sylvania, OH), Iroquois Memorial Hospital And Resident Home (Saint Anne, IL), Illinois Emergency Medicine Specialists, LLC (Bolingbrook, IL), Lawrence County Memorial Hospital (Lawrenceville, IL) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kamran Rafiq's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kamran Rafiq accept?

Health plans from CareSource and Wellmark Health Plan of Iowa, Inc. list Kamran Rafiq 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 Kamran Rafiq affiliated with any hospitals?

According to CMS data, Kamran Rafiq is affiliated with Lawrence County Memorial Hospital, Iroquois Memorial Hospital, Paulding County Hospital and Promedica Defiance Regional Hospital.

When was this NPI record last updated?

The NPPES record for Kamran Rafiq was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.