FAFA HUBERTA KOUDORO (MD) – Diagnostic Radiology Physician, NPI 1053847780
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,458 DIAGNOSTIC RADIOLOGY in NC
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Provider Addresses for FAFA HUBERTA KOUDORO (MD)
Saint Vincent Hospital at Worcester Medical Center, 123, Summer Street, Lincoln Square, Belmont Hill, Worcester, Worcester County, Massachusetts, 01608, United States
WORCESTER, MA 01608
Phone:
Type: Mailing
UNC Medical Center, 101, Manning Drive, Downtown, Chapel Hill, Orange County, North Carolina, 27514, United States
CHAPEL HILL, NC 27514
Phone: (984) 974-7836
Type: Location
20 YORK ST
NEW HAVEN, CT 065103220
Phone: (203) 688-4242
Type: Mailing
100 HAZARD AVE STE 100
ENFIELD, CT 060825447
Phone: (860) 289-3375
Type: Mailing
1260 SILAS DEANE HWY STE 104
WETHERSFIELD, CT 061094363
Phone: (860) 289-3375
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-06-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221101000529 | I | Diagnostic Radiology | CT | TBD |
| I20230612003010 | I | Diagnostic Radiology | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| A9585 | Injection, gadobutrol, 0.1 ml | 3,095 | 39 | $0 |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1,270 | 13 | $0 |
| 70450 | Ct scan head or brain without contrast | 82 | 77 | $0 |
| 72148 | Mri scan of lower spinal canal without contrast | 63 | 62 | $0 |
| 70553 | Mri scan of brain before and after contrast | 53 | 53 | $0 |
Insurance plans in this area (ZIP 01608)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology, Interventional Radiology | CT | |
| Diagnostic Radiology | MA | |
| - | CT | |
| Diagnostic Radiology | NY | |
| - | CT | |
| Diagnostic Radiology | TX | |
| Diagnostic Radiology | CT | |
| Diagnostic Radiology, Interventional Radiology | CT | |
| - | CT | |
| Diagnostic Radiology | CT |
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