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About Dr. Raisa I. Balbuena Merle
Background and practice information
Dr. Raisa I. Balbuena Merle is a pathologist with over 14 years of clinical experience serving patients in the New Haven, CT area. She completed her medical training at University Of Puerto Rico School Of Medicine and has been in practice since 2012. She currently practices at Yale University.
Dr. Raisa I. Balbuena Merle participates in Medicare's quality reporting program with a score of 73.6 out of 100. Dr. Raisa I. Balbuena Merle is in-network with 1 insurance provider, including Medicare. Patients are encouraged to verify coverage with her office before scheduling an appointment.
Additional specialties: Hematology
At a Glance
Education
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Claim this profilePractice Locations
2 locations
Yale University
Primary20 York St
New Haven, CT 06510
(203) 688-4242
Yale University
800 Howard Ave
New Haven, CT 06519
(203) 785-2140
Affiliations
Hospital and facility affiliations
Treatment & Experience
Clinical practice and procedure experience for Dr. Raisa I. Balbuena Merle
Services & Procedures
Dr. Raisa I. Balbuena Merle's clinical practice encompasses diagnostic testing.
Diagnostic Testing
55 servicesDr. Raisa I. Balbuena Merle orders and interprets diagnostic tests to support clinical decision-making, with blood smear being a key part of her practice. Medicare patients typically pay significantly less than the standard charge for these services, with Medicare-approved rates averaging 81% below the billed amount.
Source: CMS Medicare Provider Utilization and Payment Data, 2023.
Insurance Networks
Accepted insurance plans and networks
Dr. Raisa I. Balbuena Merle accepts 1 plan from 1 insurer, including Medicare.
Source: CMS Transparency in Coverage filings (March 2026). Network participation may change — verify with the provider's office before scheduling.
Quality & Safety
CMS quality performance and patient safety measures
Average
CMS Quality Score · Out of 100
Dr. Balbuena Merle received a quality score of 73.6 out of 100 from the Centers for Medicare & Medicaid Services (CMS). This score reflects performance across clinical quality measures, care coordination, and use of health technology. CMS evaluates pathologists annually through the Merit-based Incentive Payment System (MIPS) to help patients make informed choices about their healthcare in New Haven, CT.
Clinical Quality
75.8/100Measures the quality of care provided based on clinical outcomes and patient safety
Cost Efficiency
51.4/100Evaluates how efficiently healthcare resources are used while maintaining quality
Health IT Adoption
74.0/100Measures adoption of electronic health records and patient access to health information
Care Improvement
40.0/40Reflects participation in activities that improve clinical practice and patient engagement
Source: CMS Merit-based Incentive Payment System
Patient Reviews
Reviews and ratings from patients
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About Pathology
Specialty overview and common conditions
A pathologist is a physician who specializes in diagnosing disease by examining tissues, cells, and body fluids. These medical experts analyze biopsy specimens, perform autopsies, oversee clinical laboratory operations, and provide critical diagnostic information that guides treatment decisions. Pat...
Common conditions treated by pathology specialists:
- Cancer Diagnosis and Staging
- Biopsy Interpretation
- Cytology and Pap Smear Analysis
- Molecular Pathology and Genetic Testing
Frequently Asked Questions
Common questions about Raisa I. Balbuena Merle
Does Dr. Balbuena Merle accept Medicare?
Yes, Dr. Balbuena Merle accepts Medicare assignment. Patients with Medicare coverage can see Dr. Balbuena Merle and typically pay less out of pocket when using a provider who accepts Medicare assignment.
What insurance does Dr. Balbuena Merle accept?
Dr. Balbuena Merle is in-network with 1 insurance provider, including Medicare. Insurance networks can change, so patients should verify their specific plan coverage directly with Dr. Balbuena Merle's office before scheduling.
Does Dr. Balbuena Merle offer telehealth or virtual appointments?
Dr. Balbuena Merle does not currently list telehealth services. For virtual care options, contact the office directly or consider other pathology providers in New Haven who offer telehealth.
What conditions does Dr. Balbuena Merle treat?
As a pathology specialist, Dr. Balbuena Merle commonly treats conditions including cancer diagnosis and staging, biopsy interpretation, cytology and pap smear analysis, molecular pathology and genetic testing, clinical laboratory medicine, and other related health concerns. Contact the office to discuss your specific healthcare needs.
What is Dr. Balbuena Merle's quality rating?
Dr. Balbuena Merle has received a satisfactory quality score of 73.6 out of 100 from the Centers for Medicare & Medicaid Services (CMS) through the Merit-based Incentive Payment System (MIPS). This score reflects performance across quality measures, promoting interoperability, improvement activities, and cost efficiency.
Where did Dr. Balbuena Merle go to medical school?
Dr. Balbuena Merle completed medical training at University Of Puerto Rico School Of Medicine and has been practicing since 2012, bringing over 14 years of clinical experience.
Where is Dr. Balbuena Merle's office located?
Dr. Balbuena Merle practices at 20 YORK ST, New Haven, CT 06510 at YALE UNIVERSITY. You can reach the office by calling (203) 688-4242.
How do I make an appointment with Dr. Balbuena Merle?
To schedule an appointment with Dr. Balbuena Merle, call the office at (203) 688-4242. New patients should have their insurance information and medical records ready when calling.
Data source: CMS National Provider Registry ·
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Medical Disclaimer: This content is for informational purposes only and is not a substitute for professional medical advice. Learn more about our editorial standards