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RAFAEL OTERO
NPI 1790289791
Internal Medicine in Brownsville, TX

Active since March 23, 2018PECOS EnrolledAccepts Medicare Assignment
832 RIDGEWOOD ST STE B, BROWNSVILLE, TX 78520(956) 667-5298(956) 667-5299 Get Directions Write a Review

NPPES record last updated: November 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2022, Jul 20, 2021, May 11, 2021 and 1 more (4 updates tracked since 2018).

About Rafael Otero NPPES

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

RAFAEL OTERO (NPI 1790289791) is an individual internal medicine provider in Brownsville, Texas, licensed in Florida (ME148423) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS, is affiliated with Valley Baptist Medical Center- Brownsville, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1790289791
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameRAFAEL OTERO
Location Address832 RIDGEWOOD ST STE BBrownsville, TX 78520-0102
Mailing Address832 Ridgewood St Ste BBrownsville, TX 78520-0102 · (956) 667-5298 · Fax (956) 667-5299
Phone(956) 667-5298
Fax(956) 667-5299
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateMarch 23, 2018
Last NPPES UpdateNovember 11, 20224 updates tracked since enumeration
NPPES CertifiedNovember 11, 2022
✔ NPI 1790289791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in FL · ME148423✔ Licensed in TX · T4446
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
832 RIDGEWOOD ST STE B, Brownsville, TX 78520
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Rafael Otero is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103226493
PECOS Enrollment IDI20221025001693
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.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
156 services65 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
132 services53 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
89 services41 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
69 services36 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
48 services46 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
36 services33 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Valley Baptist Medical Center- Brownsville

Acute Care Hospitals · Brownsville, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450028
Location1040 W Jefferson StBrownsville, TX 78520 · Cameron County
Emergency services Birthing friendly

Vhs Harlingen Hospital Company LLC

Acute Care Hospitals · Harlingen, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450033
Location2101 Pease StHarlingen, TX 78550 · Cameron County
Emergency services Birthing friendly

Valley Regional Medical Center

Acute Care Hospitals · Brownsville, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450662
Location100 A Alton GloorBrownsville, TX 78526 · Cameron County
Emergency services Birthing friendly

Doctors Hosptal At Renaissance

Acute Care Hospitals · Edinburg, TX
3/5 CMS rating
OwnershipPhysician
CMS Certification Number450869
Location5501 South MccollEdinburg, TX 78539 · Hidalgo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78520 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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 2

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

RGV HEALTH MEDICAL CLINIC, PLLC
Clinic/Center (Primary Care)
832 RIDGEWOOD ST STE B
BROWNSVILLE, TX 78520
Cameron County (956) 667-5298
ORYANA OTERO
Internal Medicine
832 RIDGEWOOD ST STE B
BROWNSVILLE, TX 78520
Cameron County (956) 667-5298

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rafael Otero's NPI number?

The NPI number for Rafael Otero is 1790289791. It was assigned to this individual provider in the NPPES registry on March 23, 2018.

Where is Rafael Otero located?

Rafael Otero practices at 832 Ridgewood St Ste B, Brownsville, TX 78520. The listed phone number is (956) 667-5298.

What is Rafael Otero's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rafael Otero enrolled in Medicare?

Yes. Rafael Otero is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Rafael Otero accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Rafael Otero as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Rafael Otero affiliated with any hospitals?

According to CMS data, Rafael Otero is affiliated with Valley Baptist Medical Center- Brownsville, Vhs Harlingen Hospital Company LLC, Valley Regional Medical Center and Doctors Hosptal At Renaissance.

When was this NPI record last updated?

The NPPES record for Rafael Otero was last updated on November 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.