Individual provider Active NPI

Carla Marie Rafferty, MD

  • Family Medicine Physician
  • Urbana, IL
National Provider Identifier
1578719316
Registry record updated May 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.055554 Issued in IL
Practice address
1818 E Windsor Rd
Urbana, IL 61802-9566
Phone
(217) 255-9646
Fax
(217) 326-1777
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.055554 IL Primary

Addresses

Primary practice location

1818 E Windsor Rd
Urbana, IL 61802-9566

Mailing address

611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6792

Other names 1

  • Miss Carla Marie Bilotto Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110613000857 IL Practitioner - Family Practice 6507043825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.055554ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Family Medicine CurrentSince May 9, 2011 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1818 E Windsor Rd
Urbana, IL 61802
Phone (217) 255-9646

Interoperability endpoints

  • Direct secure messaging: carla.rafferty.1@14258.direct.athenahealth.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 2

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1578719316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E WINDSOR RD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618029566",
            "telephone_number": "217-255-9646",
            "fax_number": "217-326-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFFERTY",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.055554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "BILOTTO",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.