Doctor profile · Federal record
Dr. Rafael Rafols, M.D.
Family Medicine Physician (CMS: Family Practice) · Edinburg, TX
- NPI 1609028612
- Accepts Medicare
- MIPS 5.8 / 100 · 2023
- 21 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
5509 Doctors Dr
Edinburg, TX 785395563
(956) 362-5525
fax (956) 362-5530 - Mailing address
-
2701 Santa Laura
Mission, TX 785727977
Credentials & registration
- NPI registered
- October 2008 — 18 yrs on file
- Profile last updated
- October 25, 2017
- Year of graduation
- 2005 — 21 yrs since
- Specialty taxonomy
- 207Q00000X — NUCC code
- State license (1)
- Texas #N4016
- Medicaid
- TX #290522601
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1609028612. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
1,838
Distinct HCPCS
10
Medicare allowed
$174,871
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
99308 |
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 307 | 52 | $71 | |
99308 |
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 249 | 47 | $71 | |
99222 |
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 230 | 179 | $123 | |
99232 |
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 222 | 96 | $76 | |
99214 |
Established patient office or other outpatient visit, 30-39 minutes | 182 | 67 | $94 | |
99233 |
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 164 | 52 | $114 | |
99214 |
Established patient office or other outpatient visit, 30-39 minutes | 136 | 47 | $122 | |
11042 |
Removal of skin and tissue, 20.0 sq cm or less | 63 | 26 | $122 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 55 | 32 | $85 | |
99213 |
Established patient office or other outpatient visit, 20-29 minutes | 43 | 29 | $63 |
In context: peer comparison
Among 21 peers in this city , average services per provider: 89. This provider delivers 21× the peer median.Open Payments
Industry payments received
All-time total
$8,052
Transactions
16
Manufacturers
4
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| ConvaTec Inc. | 11 | $7,842.57 | |
| ABBVIE INC. | 2 | $146.76 | |
| Smith+Nephew, Inc. | 2 | $41.54 | |
| RedDress USA, Inc. | 1 | $21.41 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
685
Patients
459
Total drug cost
$261,286
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Santyl (Collagenase Clostridium Hist.) | Brand | 248 | 134 | $253,400 |
| Doxycycline Hyclate | Generic | 106 | 79 | $1,841 |
| Levofloxacin | Generic | 64 | 54 | $353 |
| Amoxicillin-Clavulanate Potass (Amoxicillin/Potassium Clav) | Brand | 40 | 38 | $519 |
| Sulfamethoxazole-Trimethoprim (Sulfamethoxazole/Trimethoprim) | Brand | 36 | 30 | $283 |
| Gentamicin Sulfate | Generic | 32 | 23 | $2,065 |
| Triamcinolone Acetonide | Generic | 27 | 12 | $517 |
| Clotrimazole | Generic | 22 | 16 | $552 |
| Nystatin | Generic | 22 | 17 | $397 |
| Mupirocin | Generic | 18 | 16 | $212 |
Frequently asked questions
What is Dr. Rafael Rafols's medical specialty?
Dr. Rafael Rafols practices Family Medicine Physician in Edinburg, TX.
Where does Dr. Rafael Rafols practice?
Dr. Rafael Rafols practices at 5509 Doctors Dr, Edinburg, TX 785395563. Office phone: 9563625525.
What is Dr. Rafael Rafols's NPI?
Dr. Rafael Rafols's National Provider Identifier (NPI) is 1609028612, issued by NPPES.
Does Dr. Rafael Rafols accept Medicare assignment?
Yes. Dr. Rafael Rafols accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Rafael Rafols commonly perform?
Top Medicare-reported procedures in 2023: Subsequent nursing facility care with straightforward level of medical decision making (HCPCS 99308); Subsequent nursing facility care with straightforward level of medical decision making (HCPCS 99308); Initial hospital care with straightforward or low-level medical decision making (HCPCS 99222). Source: CMS Medicare Physician & Other Practitioners file.