Fafa Huberta Koudoro, MD - Medicare Diagnostic Radiology in Wethersfield, CT

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Fafa Huberta Koudoro, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Wethersfield, Connecticut. She went to George Washington University School Of Medicine and graduated in 2017 and has 9 years of diverse experience with area of expertise as Diagnostic Radiology. She is a member of the group practice Connecticut Imaging Partners Llc, Connecticut Imaging Partners Llc, Smi Imaging Llc, Danbury Radiological Associates, Pc, Premier Imaging Llc, Farmington Imaging Center Llc, Farmington Imaging Center Llc, Tic Llc, Jefferson Radiology Pc and her current practice location is 1260 Silas Deane Hwy Ste 104, Wethersfield, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 289-3375.

Fafa Huberta Koudoro is licensed to practice in Connecticut (license number 72410) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1053847780.

Contact Information

Fafa Huberta Koudoro, MD
1260 Silas Deane Hwy Ste 104,
Wethersfield, CT 06109-4363
(860) 289-3375
Not Available

Map and Direction




Physician's Profile

Full NameFafa Huberta Koudoro
GenderFemale
SpecialityDiagnostic Radiology
Experience9 Years
Location1260 Silas Deane Hwy Ste 104, Wethersfield, Connecticut
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Fafa Huberta Koudoro attended and graduated from George Washington University School Of Medicine in 2017
  NPI Data:
  • NPI Number: 1053847780
  • Provider Enumeration Date: 05/01/2017
  • Last Update Date: 04/24/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 9638443039
  • Enrollment ID: I20221101000529

Medical Identifiers

Medical identifiers for Fafa Huberta Koudoro such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053847780NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 72410 (Connecticut)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Hartford HospitalHartford, CTHospital
Manchester Memorial HospitalManchester, CTHospital
Griffin HospitalDerby, CTHospital
Day Kimball HospitalPutnam, CTHospital
Danbury HospitalDanbury, CTHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Connecticut Imaging Partners Llc4183649098105
Connecticut Imaging Partners Llc4183649098105
Smi Imaging Llc3476696220380
Danbury Radiological Associates, Pc226440853335
Premier Imaging Llc882040363742
Farmington Imaging Center Llc771926565168
Farmington Imaging Center Llc771926565168
Tic Llc488097281952
Jefferson Radiology Pc8729982525121

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Fafa Huberta Koudoro allows following entities to bill medicare on her behalf.
Entity NameTrinity Health of New England Provider Network Organization Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003882812
PECOS PAC ID: 0941113567
Enrollment ID: O20031110000651
Entity NameJefferson Radiology PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396795951
PECOS PAC ID: 8729982525
Enrollment ID: O20031124000161
Entity NameDanbury Radiological Associates, PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639164106
PECOS PAC ID: 2264408533
Enrollment ID: O20040908000695
Entity NameConnecticut Imaging Partners LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740315761
PECOS PAC ID: 4183649098
Enrollment ID: O20051011000041
Entity NameTic LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457702813
PECOS PAC ID: 4880972819
Enrollment ID: O20161026002352
Entity NameFarmington Imaging Center LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275987802
PECOS PAC ID: 7719265651
Enrollment ID: O20161028000552
Entity NameSimonmed Imaging Florida LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477830818
PECOS PAC ID: 6608036108
Enrollment ID: O20200108002116
Entity NameSmi Imaging LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972004489
PECOS PAC ID: 3476696220
Enrollment ID: O20200108002428
Entity NamePremier Imaging LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1760087027
PECOS PAC ID: 8820403637
Enrollment ID: O20210208002687
Entity NameAdvanced Imaging Specialists LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1689429078
PECOS PAC ID: 9234676164
Enrollment ID: O20240808003398
Entity NameDesert Advanced Imaging Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568416147
PECOS PAC ID: 6406749613
Enrollment ID: O20240917002306
Entity NameBeverly Radiology Medical Group III
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962457812
PECOS PAC ID: 3476466376
Enrollment ID: O20241029000575
Entity NameArizona Diagnostic Radiology Group LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336757699
PECOS PAC ID: 1658796859
Enrollment ID: O20241230000893

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Fafa Huberta Koudoro is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Fafa Huberta Koudoro, MD
100 Hazard Ave Ste 100,
Enfield, CT 06082-5447

Ph: (860) 289-3375		Fafa Huberta Koudoro, MD
1260 Silas Deane Hwy Ste 104,
Wethersfield, CT 06109-4363

Ph: (860) 289-3375

Reviews and Comments


Radiology Doctors in Wethersfield, CT

Lindsay M Griffin, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 1260 Silas Deane Hwy Ste 100, Wethersfield, CT 06109
Phone: 860-289-3375    Fax: 860-290-4108

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.