Rafael J. Rafols, M.D.
NPI 1609028612ActiveIndividual· Family Medicine· Edinburg, TX
Family Medicine (M.D.) with Rafael Rafols MD PA, practicing in Edinburg, Texas. In 2024 Medicare paid $1,004,834 for 412 patients, and Part D covered 599 of their prescriptions, 71% of them generic. Convatec Inc. was the largest of 3 companies reporting payments in 2025, $4,392 in all, mostly consulting fees. Lists Doctors Hosptal at Renaissance and 2 other hospitals as hospital affiliations.
Overview
| NPI | 1609028612 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Oct 21, 2008 |
| Last updated in NPPES | Oct 25, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | N4016 | TX |
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 - Family Practice (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 412 |
|---|---|
| Services billed | 3,713 across 42 procedure codes |
| Paid by Medicare | $1,004,834 |
Part D prescriptions in 2024
| Prescriptions (claims) | 599 · 604 30-day fills |
|---|---|
| Patients | 295 |
| Total drug cost | $130,921 |
| Generic share | 71% of claims |
Education and affiliations
| Graduation year | 2005 |
|---|---|
| Medicare specialty | Family Practice |
| Telehealth | Offers telehealth |
Medical group
- Rafael Rafols MD PAMission, TX · 2 clinicians
Hospital affiliations
- Doctors Hosptal at RenaissanceEdinburg, TX
- Rio Grande Regional HospitalMcAllen, TX
- South Texas Health SystemEdinburg, TX
Other facilities
- Infinity Care Home Health LLCHome health agency · McAllen, TX
- New Life Home Health ServicesHome health agency · Donna, TX
- Saint Matthew Home Health Care LLCHome health agency · Pharr, TX
- Verge Home Care LLCHome health agency · Edinburg, TX
- Solara Specialty Hospital McAllenLong-term care hospital · Mc Allen, TX
- Solara Specialty Hospitals HarlingenLong-term care hospital · Harlingen, TX
- Veranda Rehabilitation and HealthcareNursing home · Harlingen, TX
Industry payments (Open Payments)
- 2025$4,392 · 19 payments from 3 companies
- 2024$8,052 · 16 payments from 4 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Convatec Inc. | $4,039 | 5 |
| Smith+nephew, Inc. | $320.53 | 13 |
| Amnio Technology, LLC | $32.47 | 1 |
What the 2025 payments were for
- Consulting Fee$2,400 · 1 payment
- Travel and Lodging$1,488 · 2 payments
- Food and Beverage$504.58 · 16 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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