NPIMap

Individual provider Active NPI

Ahmad Nadeem Rafi, M.D.

  • Anesthesiology Physician
  • Russellville, AR
National Provider Identifier
1285671487
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-4802 Issued in AR
Practice address
1660 W C PL
Russellville, AR 72801-2705
Phone
(479) 967-7770
Fax
(479) 967-7772
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-4802 AR Primary

Addresses

Primary practice location

1660 W C PL
Russellville, AR 72801-2705

Mailing address

32 Courts Dr
Little Rock, AR 72223-9021
Phone (501) 821-1117

Other identifiers 1

IdentifierTypeStateIssuer
162931001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060920000131 AR Practitioner - Pain ManagementPractitioner - Anesthesiology 4082619382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr R Anesthesia and Pain Management PAGroup PAC ID 8820410111, 2 clinicians

Practice addresses (Care Compare)

3110 W Main St
Russellville, AR 72801-2455
Phone (479) 967-7770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.76 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-4802ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sark Opl CurrentSince Sep 1, 2020 Accepting new patients
Dr R Anesthesia & Pain Management PA Anesthesiology CurrentSince Jun 4, 2014 Accepting new patients
River Valley Surgery Center PLLC CurrentSince Oct 23, 2022 Accepting new patients

Locations

1507 Linwood Dr
Paragould, AR 72450
Phone (870) 239-8105

7200 S Hazel St
Pine Bluff, AR 71603
Phone (870) 534-2900

1660 W C Pl
Russellville, AR 72801
Phone (479) 498-6753

2504 W Main St
Ste H
Russellville, AR 72801
Phone (479) 967-6492

3110 W Main St
Russellville, AR 72801
Phone (479) 967-7770

Interoperability endpoints

  • Direct secure messaging: ahmad.rafi@3619.securemail.prognocis.com

Organizations & group practices 3

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

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1285671487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 COURTS DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239021",
            "telephone_number": "501-821-1117",
            "fax_number": "501-450-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 W C PL",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012705",
            "telephone_number": "479-967-7770",
            "fax_number": "479-967-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFI",
        "first_name": "AHMAD",
        "middle_name": "NADEEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-4802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162931001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.