Rafael J Rafols, MD - Medicare Family Practice in Edinburg, TX

Rafael J Rafols, MD is a medicare enrolled "Family Medicine" physician in Edinburg, Texas. He graduated from medical school in 2004 and has 20 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Rafael Rafols Md Pa and his current practice location is 5509 Doctors Dr, Edinburg, Texas. You can reach out to his office (for appointments etc.) via phone at (956) 362-5525.

Rafael J Rafols is licensed to practice in Texas (license number N4016) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1609028612.

Contact Information

Rafael J Rafols, MD
5509 Doctors Dr,
Edinburg, TX 78539-5563
(956) 362-5525
(956) 362-5530

Map and Direction




Physician's Profile

Full NameRafael J Rafols
GenderMale
SpecialityFamily Practice
Experience20 Years
Location5509 Doctors Dr, Edinburg, Texas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Rafael J Rafols graduated from medical school in 2004
  NPI Data:
  • NPI Number: 1609028612
  • Provider Enumeration Date: 10/21/2008
  • Last Update Date: 10/25/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 7214077007
  • Enrollment ID: I20091230000192

Medical Identifiers

Medical identifiers for Rafael J Rafols such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609028612NPI-NPPES
290522601MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine N4016 (Texas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Saint Matthew Home Health Care LlcPharr, TXHome health agency
Genuine Healthcare Services IncMcallen, TXHome health agency
Only Love Home CareMcallen, TXHome health agency
Alegre Home Health Care LlcMission, TXHome health agency
Doctors Hospital At RenaissanceEdinburg, TXHospital
South Texas Health SystemEdinburg, TXHospital
Vhs Harlingen Hospital Company LlcHarlingen, TXHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Rafael Rafols Md Pa71131937646

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Rafael J Rafols allows following entities to bill medicare on his behalf.
Entity NameValley Urgent Care, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649453200
PECOS PAC ID: 8325064454
Enrollment ID: O20051018001132
Entity NameRafael Rafols Md Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891071106
PECOS PAC ID: 7113193764
Enrollment ID: O20120103000130

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Rafael J Rafols is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Rafael J Rafols, MD
2701 Santa Laura,
Mission, TX 78572-7977

Ph: (956) 627-4796
Rafael J Rafols, MD
5509 Doctors Dr,
Edinburg, TX 78539-5563

Ph: (956) 362-5525

Reviews and Comments


Family Medicine Doctors in Edinburg, TX

Henrietta J Peynado, MSN,RN,FNP-BC,OCN
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Phone: 956-362-3780    Fax: 956-362-3793
Dr. Maria C Arango, MD
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Noel E Oliveira, MD
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Mr. Jose A Lopez, MD
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Desmond Okey Ikondu, MD
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Phone: 956-630-2119    Fax: 956-682-6115
Dr. Naomi Jane D'acolatse, M.D.
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Medicare: Medicare Enrolled
Practice Location: 1601 E Sprague St, Edinburg, TX 78542
Phone: 956-362-8383    Fax: 956-362-8382
Belinda V Jordan, MD
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Practice Location: 5500 Raphael Dr, Edinburg, TX 78539
Phone: 956-362-5673    Fax: 956-362-2038

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.