MR. RAPHAEL OMOTO CNP
NPI 1245939495
Nurse Practitioner - Psychiatric/Mental Health in Minneapolis, MN

Q: What is Raphael Omoto's NPI number?

The NPI number for Raphael Omoto is 1245939495. It was assigned to this individual provider in the NPPES registry on February 27, 2023. The provider is also known as Mr. Raphael Omoto Cnp.

Q: What is Raphael Omoto's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Raphael Omoto was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 27, 2023PECOS Enrolled

2215 E LAKE ST, MINNEAPOLIS, MN 55407(612) 596-9438 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2026, Jul 7, 2023, Mar 6, 2023 and 1 more (4 updates tracked since 2023).

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About Mr. Raphael Omoto Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RAPHAEL OMOTO CNP (NPI 1245939495) is an individual psychiatric/mental health provider in Minneapolis, Minnesota, licensed in Minnesota (9968) and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245939495

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. RAPHAEL OMOTOCredential: CNP

Location Address2215 E LAKE STMinneapolis, MN 55407-4385

Mailing Address7420 Unity Ave N Ste 310cBrooklyn Park, MN 55443-3162 · (612) 212-2595

Phone(612) 596-9438

Sole ProprietorYes

Enumeration DateFebruary 27, 2023

Last NPPES UpdateApril 2, 20264 updates tracked since enumeration

NPPES CertifiedApril 2, 2026

✔ NPI 1245939495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in MN · 9968

2215 E LAKE ST, Minneapolis, MN 55407

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Other Names 1

Professional Name (2)Mr. Raphael Omoto Cnp

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Raphael Omoto Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55407 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SEARE SHIBESHI

Social Worker (Clinical)