2026 NPPES data Student in an Organized Health Care Education/Training Program NPI 1366893976 MD
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Marc Rafols, MD

Student in an Organized Health Care Education/Training Program in Miami Beach, Florida. This profile is drawn from the federal National Provider Identifier Registry (CMS NPPES), which lists more than 7 million U.S. healthcare providers — including 331,761 in Student in an Organized Health Care Education/Training Program, and covers specialty classification, practice address, and Medicare Part D prescribing data when reported. According to CMS, every field reflects the provider's official federal registration — see our methodology.

Federal data — no proprietary rating. We show these CMS records as-is — no composite score, no star rating, no editorial opinion layered on top.
Prescribing volume
75
Medicare Part D claims · 45 beneficiaries · Student in an Organized Health Care Education/Training Program avg: 459
MIPS score
97.6/100
▲ 14 pts above national avg 83.1 · Exceptional
Industry payments
$145.47
5 payments · CMS Open Payments (Sunshine Act)
Compiled from official public sources by the PlainDoctor editorial team.

What the federal data shows

Marc Rafols, MD reported a CMS MIPS final score of 97.6/100 - above the 83.1 national average - and filed 75 Medicare Part D claims in 2023.

97.6/100
MIPS score · +14 vs avg
75
Part D claims, 2023
$145.47
industry payments (Sunshine Act)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

Marc Rafols, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

98 Top 15% higher than 85% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Where Marc Rafols, MD sits

This provider among student in an organized health care education/training program peers

Across the 12,645 student in an organized health care education/training program providers who report both Medicare Part D prescribing and a MIPS quality score, Marc Rafols, MD writes more Part D claims than 20% of them and scores higher on MIPS quality than 85% - placing this provider in the lower-volume, high-quality quadrant. Volume reflects patient-panel size and specialty, not quality; the two axes are independent.

Part D claim volume vs MIPS quality, by specialty percentile

Lower volume · High qualityHigh volume · High qualityLower volume · Lower qualityHigh volume · Lower quality02550751000255075100Part D claim volume, percentile in specialtyMIPS quality, percentilePart D claim volume, percentile in specialty: 52 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 17 · MIPS quality, percentile: 13Part D claim volume, percentile in specialty: 77 · MIPS quality, percentile: 72Part D claim volume, percentile in specialty: 65 · MIPS quality, percentile: 98Part D claim volume, percentile in specialty: 80 · MIPS quality, percentile: 78Part D claim volume, percentile in specialty: 93 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 82 · MIPS quality, percentile: 67Part D claim volume, percentile in specialty: 92 · MIPS quality, percentile: 7Part D claim volume, percentile in specialty: 50 · MIPS quality, percentile: 28Part D claim volume, percentile in specialty: 28 · MIPS quality, percentile: 53Part D claim volume, percentile in specialty: 35 · MIPS quality, percentile: 52Part D claim volume, percentile in specialty: 7 · MIPS quality, percentile: 35Part D claim volume, percentile in specialty: 33 · MIPS quality, percentile: 50Part D claim volume, percentile in specialty: 48 · MIPS quality, percentile: 68Part D claim volume, percentile in specialty: 78 · MIPS quality, percentile: 2Part D claim volume, percentile in specialty: 8 · MIPS quality, percentile: 8Part D claim volume, percentile in specialty: 75 · MIPS quality, percentile: 63Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 95Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 20Part D claim volume, percentile in specialty: 13 · MIPS quality, percentile: 22Part D claim volume, percentile in specialty: 87 · MIPS quality, percentile: 48Part D claim volume, percentile in specialty: 55 · MIPS quality, percentile: 43Part D claim volume, percentile in specialty: 32 · MIPS quality, percentile: 80Part D claim volume, percentile in specialty: 53 · MIPS quality, percentile: 65Part D claim volume, percentile in specialty: 0 · MIPS quality, percentile: 82Part D claim volume, percentile in specialty: 25 · MIPS quality, percentile: 12Part D claim volume, percentile in specialty: 43 · MIPS quality, percentile: 73Part D claim volume, percentile in specialty: 45 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 3 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 2 · MIPS quality, percentile: 10Part D claim volume, percentile in specialty: 37 · MIPS quality, percentile: 33Part D claim volume, percentile in specialty: 27 · MIPS quality, percentile: 97Part D claim volume, percentile in specialty: 68 · MIPS quality, percentile: 45Part D claim volume, percentile in specialty: 95 · MIPS quality, percentile: 58Part D claim volume, percentile in specialty: 100 · MIPS quality, percentile: 25Part D claim volume, percentile in specialty: 97 · MIPS quality, percentile: 98Part D claim volume, percentile in specialty: 85 · MIPS quality, percentile: 3Part D claim volume, percentile in specialty: 58 · MIPS quality, percentile: 37Part D claim volume, percentile in specialty: 72 · MIPS quality, percentile: 92Part D claim volume, percentile in specialty: 88 · MIPS quality, percentile: 75Part D claim volume, percentile in specialty: 98 · MIPS quality, percentile: 93Part D claim volume, percentile in specialty: 63 · MIPS quality, percentile: 0Part D claim volume, percentile in specialty: 70 · MIPS quality, percentile: 55Part D claim volume, percentile in specialty: 22 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 67 · MIPS quality, percentile: 27Part D claim volume, percentile in specialty: 73 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 60 · MIPS quality, percentile: 77Part D claim volume, percentile in specialty: 12 · MIPS quality, percentile: 22Part D claim volume, percentile in specialty: 40 · MIPS quality, percentile: 47Part D claim volume, percentile in specialty: 57 · MIPS quality, percentile: 18Part D claim volume, percentile in specialty: 5 · MIPS quality, percentile: 83Part D claim volume, percentile in specialty: 42 · MIPS quality, percentile: 17Part D claim volume, percentile in specialty: 18 · MIPS quality, percentile: 32Part D claim volume, percentile in specialty: 62 · MIPS quality, percentile: 38Part D claim volume, percentile in specialty: 30 · MIPS quality, percentile: 90Part D claim volume, percentile in specialty: 23 · MIPS quality, percentile: 15Part D claim volume, percentile in specialty: 47 · MIPS quality, percentile: 5Part D claim volume, percentile in specialty: 83 · MIPS quality, percentile: 62Part D claim volume, percentile in specialty: 10 · MIPS quality, percentile: 40Part D claim volume, percentile in specialty: 90 · MIPS quality, percentile: 30Marc Rafols, MD-Part D claim volume, percentile in specialty: 20 · MIPS quality, percentile: 85
Part D claim volume vs MIPS quality, by specialty percentile

Each dot is one student in an organized health care education/training program peer from a representative sample of 60; the gold marker is Marc Rafols, MD. Source: CMS Medicare Part D Prescriber data and the CMS Merit-based Incentive Payment System, 2023.

What does the federal data show about Marc Rafols, MD?

High performer (top quartile)

NPI registry status

Active

Issued 06/24/2016

NPI 1366893976

Primary specialty

Student in an Organized Health Care Education/Training Program

High-volume

331,761 US NPIs in this specialty

Medicare Part D claims

75 84% vs specialty avg

2023 prescription claims

Specialty avg: 459

MIPS final score

97.6/100 14.5 pts vs avg

Exceptional band

vs 83.1 national avg

Specialty distribution in Florida

How Student in an Organized Health Care Education/Training Program compares to other specialties among Florida providers

Florida providers

Largest specialties in Florida (% of in-state providers)

Behavior Technician - 16.1%Behavior Technician16.1%Mental Health Counselor - 4.8%Mental Health Counselor4.8%Family Nurse Practitioner - 4.5%Family Nurse Practitioner4.5%Pharmacist - 4.2%Pharmacist4.2%Student in an Organized Health Care Education/Training Program - 3.8%Student in an Organized Health Care Education/Training Program3.8%Physical Therapist - 3.1%Physical Therapist3.1%
Largest specialties in Florida (% of in-state providers)

Medicare quality performance — MIPS

Marc Rafols, MD's 2023 MIPS final score plotted against the Student in an Organized Health Care Education/Training Program national average

High performer (top quartile)
MIPS Final Score
97.6/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Student in an Organized Health Care Education/Training Program) — 97.6/100 vs national avg 83.1

0%100%National avg83%97.6%
MIPS final score (Student in an Organized Health Care Education/Training Program) — 97.6/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

Marc Rafols, MD appears in the CMS NPPES registry as a Student in an Organized Health Care Education/Training Program provider holding MD credentials at 4300 ALTON RD, Miami Beach, FL, 33140, with a listed phone of (786) 239-1572. NPI 1366893976 was issued on 06/24/2016. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what Rafols most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 75 prescription claims written by this provider, covering 45 Medicare beneficiaries and totaling roughly $2K in drug spend, with an opioid prescribing rate of 32.0%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97.6/100 for the 2023 performance year (Quality 86.5), compared with the national average of 83.1.

Student in an Organized Health Care Education/Training Program is a high-volume specialty nationwide, with 331,761 enrolled providers across 55 states and an average of 459 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

4300 ALTON RD
Miami Beach, FL 33140

Provider Details

NPI 1366893976
Specialty Student in an Organized Health Care Education/Training Program
Credentials MD
Gender Male
NPI Issued 06/24/2016

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

97.5814
Final Score
Avg: 83.1
86.5348
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Hospital and facility affiliations

Facilities where Marc Rafols, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

Physician Practices OF Msmc LLC
Miami Beach, FL

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for Marc Rafols, MD. Source: openpaymentsdata.cms.gov.

Total received

$145

Largest payer

Lexicon Pharmaceuticals, Inc.

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

License & disciplinary context — Florida FLDOH 2023 annual report

Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~75K Florida medical licensees in 2023 — they are NOT specific to Marc Rafols, MD. To verify Marc Rafols, MD's current license status, search the FLDOH public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.

480
Total board actions, Florida 2023
Across 467 cases
6.40
Actions per 1,000 licensees
Florida statewide rate
monetary fine
Most common action type
138 cases

FLDOH publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Florida disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

75
Total Claims
$2K
Total Drug Cost
45
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
89
Total Day Supply
1,456
Generic Drug Cost
$646
Opioid Claims
24 (32.0% rate)
Antibiotic Claims
16

Patient Demographics

Average Patient Age
73.0 years
Avg HCC Risk Score
1.53
Gender Split
42% female / 58% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

Drug Claims
Oxycodone-Acetaminophen
Oxycodone Hcl/Acetaminophen
20
Gabapentin
13

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Student in an Organized Health Care Education/Training Program Overview

How Marc Rafols, MD fits within the Student in an Organized Health Care Education/Training Program landscape nationally.

331,761
Student in an Organized Health Care Education/Training Program Providers in US
55
States with Student in an Organized Health Care Education/Training Program
459
Avg Claims per Provider

Marc Rafols, MD's 75 claims are below the specialty average of 459.

Nearby Student in an Organized Health Care Education/Training Program Providers in Florida

Other clinicians with the same primary specialty enrolled in Florida, drawn from the same CMS NPPES roster as Rafols.

Compare Student in an Organized Health Care Education/Training Program nationally: see state-by-state distribution →

Before you book an appointment

Use this federal record as your verification checklist, not as a recommendation.

  • Confirm the NPI record is current in the official CMS registry — providers update their own NPPES details, and moves can lag. Verify this NPI
  • Check the active license and any disciplinary history with the Florida medical board — federal registration is not a license check. Credential verification guide
  • Weigh a second option: compare this provider with a nearby Student in an Organized Health Care Education/Training Program peer on Medicare volume and prescribing patterns. Compare providers

Medicare Part D and MIPS figures describe practice patterns in federal programs only — they are not quality ratings, and PlainDoctor does not rate, rank, or recommend providers.

Frequently Asked Questions

What is Marc Rafols, MD's specialty?
Marc Rafols, MD specializes in Student in an Organized Health Care Education/Training Program and practices in Miami Beach, Florida. Credentials: MD.
How much does Marc Rafols, MD prescribe under Medicare Part D?
In 2023, Marc Rafols, MD wrote 75 Medicare Part D claims totaling $2K in drug costs for 45 beneficiaries.
What is Marc Rafols, MD's Medicare quality score?
Marc Rafols, MD has a CMS MIPS Final Score of 97.6/100 (Quality: 86.5). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is Marc Rafols, MD located?
Marc Rafols, MD is located at 4300 ALTON RD, Miami Beach, FL, 33140. Phone: (786) 239-1572.
What is Marc Rafols, MD's NPI number?
Marc Rafols, MD's National Provider Identifier (NPI) is 1366893976, issued on 06/24/2016.
Does Marc Rafols, MD prescribe opioids?
Yes, Marc Rafols, MD had 24 opioid claims in 2023 with an opioid prescribing rate of 32.0%.
How many Student in an Organized Health Care Education/Training Program providers are there in the US?
There are 331,761 Student in an Organized Health Care Education/Training Program providers across 55 states in the US. The average Student in an Organized Health Care Education/Training Program provider writes 459 Medicare Part D claims per year.
What drugs does Marc Rafols, MD prescribe most often?
Based on 2023 Medicare Part D data, Marc Rafols, MD's most frequently prescribed drugs include Oxycodone-Acetaminophen, Gabapentin. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does Marc Rafols, MD accept Medicare?
Marc Rafols, MD appears in CMS Medicare data with 75 Part D claims and 45 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify Marc Rafols, MD's credentials?
Marc Rafols, MD's NPI is 1366893976 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology

Compiled from official public sources by the PlainDoctor editorial team.