Fafa Huberta Koudoro, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

72410 Issued in CT

Practice address

1260 Silas Deane Hwy Ste 104
Wethersfield, CT 06109-4363

Phone

(860) 289-3375

NPI assigned

May 1, 2017

Last updated

Apr 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

George Washington University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Connecticut Imaging Partners LLCGroup PAC ID 4183649098, 105 clinicians

Smi Imaging LLCGroup PAC ID 3476696220, 380 clinicians

Danbury Radiological Associates, PCGroup PAC ID 2264408533, 35 clinicians

Premier Imaging LLCGroup PAC ID 8820403637, 42 clinicians

Farmington Imaging Center LLCGroup PAC ID 7719265651, 68 clinicians

Tic LLCGroup PAC ID 4880972819, 52 clinicians

Jefferson Radiology PCGroup PAC ID 8729982525, 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hartford Hospital Hospital, Hartford, CT, CCN 070025
• Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027
• Griffin Hospital Hospital, Derby, CT, CCN 070031
• Day Kimball Hospital Hospital, Putnam, CT, CCN 070003
• Danbury Hospital Hospital, Danbury, CT, CCN 070033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Connecticut Imaging Partners, LLC

  • Diagnostic Radiology Physician
  • Wethersfield, CT
  • NPI 1740315761

  MA

  Medicare reassignment Care Compare group NPD
• Danbury Radiological Associates, PC

  • Diagnostic Radiology Physician
  • Danbury, CT
  • NPI 1639164106
  Medicare reassignment Care Compare group NPD
• Farmington Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Farmington, CT
  • NPI 1275987802

  MA

  Medicare reassignment Care Compare group NPD
• Premier Imaging LLC

  • Diagnostic Radiology Physician
  • Norwalk, CT
  • NPI 1760087027
  Medicare reassignment Care Compare group NPD
• Tic, LLC

  dba Tolland Imaging Center

  • Diagnostic Radiology Physician
  • Tolland, CT
  • NPI 1457702813
  Medicare reassignment Care Compare group NPD
• Jefferson Radiology, PC

  • Diagnostic Radiology Physician
  • Hartford, CT
  • NPI 1396795951

  MA

  Medicare reassignment Care Compare group
• Smi Imaging, LLC

  dba Simonmed Imaging

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1972004489

  CT

  Medicare reassignment Care Compare group
• Advanced Imaging Specialists, LLC

  • Diagnostic Radiology Physician
  • Hartford, CT
  • NPI 1689429078
  Medicare reassignment NPD
• Arizona Diagnostic Radiology Group, LLC

  • Diagnostic Radiology Physician
  • Gilbert, AZ
  • NPI 1336757699

  CT

  Medicare reassignment NPD
• Beverly Radiology Medical Group III

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1962457812

  CT

  Medicare reassignment NPD
• Chelmsford MRI, P.C.

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Dedham, MA
  • NPI 1386662112
  Medicare reassignment NPD
• Chelmsford MRI, P.C.

  dba Rayus Radiology

  • Diagnostic Radiology Physician
  • Springfield, MA
  • NPI 1821435553
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1205056371
  Care Compare affiliation
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1649243478
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Care Compare affiliation
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1902834880
  Care Compare affiliation
• Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1881564664
  Care Compare affiliation
• The Griffin Hospital

  • General Acute Care Hospital
  • Derby, CT
  • NPI 1184639973
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1053847780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HAZARD AVE STE 100",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060825447",
            "telephone_number": "860-289-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 SILAS DEANE HWY STE 104",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094363",
            "telephone_number": "860-289-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUDORO",
        "first_name": "FAFA",
        "middle_name": "HUBERTA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "72410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Han NA Kim, OD
• Shane P Kinsey, PAC
• Judson D Klein, LPC
• Lindsay B Knapp, LICSW
• Thomas S Kocienda, PSY.D.
• Nataliya Krayzman
• Jodee Juanita Krejmas
• Rajeev A Kulkarni, D.D.S.LLC.
• Timothy Nolan Kumnick, M.ED., BCBA, LBA
• La Sala Wellness Group, PLLC

• Diagnostic Radiology Physician in Wethersfield, CT
• Providers in Wethersfield, CT by specialty
• Diagnostic Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.