Fafa Huberta Koudoro, MD
NPI 1053847780ActiveIndividual· Radiology, Diagnostic Radiology· Wethersfield, CT
Radiology, Diagnostic Radiology (MD) in Wethersfield, Connecticut, trained at George Washington University School of Medicine (class of 2017). Medicare paid $132,699 for services to 1,265 patients in 2024.
Overview
| NPI | 1053847780 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | Yes |
| NPI issued | May 1, 2017 |
| Last updated in NPPES | Apr 24, 2026 |
| Certified by provider | Apr 24, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Diagnostic Radiology Primary | 2085R0202X | 72410 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Diagnostic Radiology (CT); Practitioner - Diagnostic Radiology (MA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 1,265 |
|---|---|
| Services billed | 7,057 across 71 procedure codes |
| Paid by Medicare | $132,699 |
Education and affiliations
| Medical school | George Washington University School of Medicine |
|---|---|
| Graduation year | 2017 |
| Medicare specialty | Diagnostic Radiology |
Medical groups
- Trinity Health of New England Provider Network Organization IncHartford, CT · 653 clinicians
- Smi Imaging LLCBeverly Hills, CA · 384 clinicians
- Jefferson Radiology PCNeedham, MA · 114 clinicians
- Connecticut Imaging Partners LLCEnfield, CT · 104 clinicians
- Farmington Imaging Center LLCNeedham, MA · 71 clinicians
- Tic LLCFurlong, PA · 53 clinicians
- Premier Imaging LLCNorwalk, CT · 46 clinicians
- Danbury Radiological Associates, PCDanbury, CT · 37 clinicians
Hospital affiliations
- Danbury HospitalDanbury, CT
- Day Kimball HospitalPutnam, CT
- Griffin HospitalDerby, CT
- Hartford HospitalHartford, CT
- Manchester Memorial HospitalManchester, CT
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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