Rafael Rafols, M.D.
NPI 1609028612 · Family Medicine Physician · Edinburg, TX
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Rafael Rafols, M.D. is a Family Medicine Physician provider in Edinburg, TX (NPI 1609028612).
Provider details
- NPI number
- 1609028612
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- N4016 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
17 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
2,757 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 35 Minutes99232 | 717 | $70 |
| Subsequent Nursing Facility Care With Straightforward Level of Medical Decision Making, Per Day, If Using Time, 20 Minutes Or More99308 | 432 | $66 |
| Subsequent Nursing Facility Care With Straightforward Level of Medical Decision Making, Per Day, If Using Time, 20 Minutes Or More99308 | 404 | $66 |
| Management of Oxygen Chamber Therapy99183 | 247 | $94 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 174 | $115 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 11 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Collagenase Clostridium Hist.brand: Santyl | 163 | 105 |
| Doxycycline Hyclate | 118 | 101 |
| Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass | 42 | 38 |
| Gentamicin Sulfate | 40 | 31 |
| Levofloxacin | 32 | 25 |
| Nystatin | 22 | 13 |
| Mupirocin | 22 | 16 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$8,052 across 16 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-10-21
- Last updated
- 2017-10-25
Frequently asked questions
- What is Rafael Rafols's NPI number?
- Rafael Rafols's National Provider Identifier (NPI) is 1609028612, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Rafael Rafols's specialty?
- Rafael Rafols is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Rafael Rafols located?
- Rafael Rafols's practice location on file with NPPES is 5509 Doctors Dr, Edinburg, TX 78539-5563.
- What is Rafael Rafols's phone number?
- The practice phone number listed in the NPPES registry for Rafael Rafols is (956) 362-5525.
- Does Rafael Rafols accept Medicare?
- Rafael Rafols is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Rafael Rafols's NPI active?
- Yes — Rafael Rafols's NPI (1609028612) is active in the NPPES registry as of the last update on 2017-10-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.