Active NPI 1245224492 Individual Practitioner Male Practitioner

Dr. Rafael A Lugo , MD

Surgery • Shenandoah, TX

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Rafael Lugo, MD is a certified Surgery practicing in Shenandoah, TX. With approximately 33 years of clinical experience since graduating from Ponce School Of Medicine in 1993, Dr. Lugo delivers high-quality medical care to the local community at 17189 I 45 S STE 275.

Dr. Lugo accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include new patient outpatient office visit, repair of groin hernia using an endoscope, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

17189 I 45 S Ste 275

Shenandoah, TX 773853326

Telephone 8323775846

Fax 8884169722

Associated Practice Facility / Clinic

🏢 Rafael A Lugo Md Pa Facility NPI 1306395793

Medicare Profile & Education

Medical School

Ponce School Of Medicine

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Shenandoah, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

33 Yrs +8.5 yrs vs City Avg

City Avg: 24.5 Yrs

State Avg: 25.2 Yrs

Regional Practice Density

18 Specialists

Practicing in Shenandoah, TX (2342 Statewide)

Telehealth Adoption Rate

22.2% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

63.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lugo (33 Years) 33 Yrs

Shenandoah Specialty Average (24.5 Years) 24.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	75	75	$420.30	$159.69
49650 Repair of groin hernia using an endoscope	22	22	$1320.92	$456.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	11	$275.22	$122.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	52	52	$420.30	$159.60
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	18	18	$520.90	$162.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	14	$293.36	$122.54
49650 Repair of groin hernia using an endoscope	13	13	$1203.68	$320.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	47	47	$420.30	$161.45
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	26	14	$185.55	$60.32
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	24	$520.90	$190.13
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	18	18	$351.50	$129.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	16	$275.22	$124.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	44	44	$420.30	$162.69
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	34	33	$369.59	$131.34
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	32	21	$185.55	$69.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	16	$275.22	$126.50
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	16	16	$520.90	$193.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	61	60	$369.57	$135.44
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	33	20	$185.55	$71.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$288.71	$104.95
43246 Insertion of stomach tube using a flexible endoscope	14	14	$532.72	$178.27
47562 Removal of gallbladder using an endoscope	13	13	$1719.20	$654.68
99213 Established patient office or other outpatient visit, typically 15 minutes	13	11	$187.05	$71.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	73	33	$185.55	$69.23
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	72	72	$516.77	$197.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$420.30	$158.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	33	32	$520.90	$198.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$426.67	$154.92
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	17	12	$185.55	$68.04
99291 Critical care, first 30-74 minutes	16	16	$703.85	$217.71
36556 Insertion of non-tunneled central venous tube for infusion (5 years or older)	13	12	$601.95	$96.54
47562 Removal of gallbladder using an endoscope	13	13	$1719.20	$643.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$414.04	$160.76

Medical Specialties & State Licenses

CMS Verified: 2022-08-23

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License TX K8309

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

401312001 (TX)

Medicaid State Provider ID

031168003 (TX)

Medicaid State Provider ID

031168004 (TX)

Medicaid State Provider ID

031168005 (TX)

Medicaid State Provider ID

031168002 (TX)

Commercial Insurance / Payer ID Aetna

5363822 (TX)

Commercial Insurance / Payer ID Hmo Blue

87670Z (TX)

Commercial Insurance / Payer ID Bcbs

8F6737 (TX)

Commercial Insurance / Payer ID Railroad Medicare

020053268 (TX)

Commercial Insurance / Payer ID Blue Cross Blue Shield

1245224492 (TX)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events

📍

Updated Practice Location June 04, 2019

Registered at 17189 I 45 S STE 275, SHENANDOAH, TX 773853326 (Tel: 8323775846)

📍

Updated Business Mailing Address June 04, 2019

Registered at PO BOX 131330, SPRING, TX 773931330 (Tel: 8323775846)

✅

NPI Profile Active April 16, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location April 16, 2017

Registered at 150 PINE FOREST DR, SUITE 404, SHENANDOAH, TX 773845302 (Tel: 8323775846)

📍

Updated Business Mailing Address April 16, 2017

Registered at 6 PEBBLE COVE CT, THE WOODLANDS, TX 773813309 (Tel: 8323775846)

👤

Provider Name / Credentials Updated April 16, 2017

Recorded as RAFAEL LUGO, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2017

Surgery (License #K8309 in TX)

📍

Updated Practice Location January 26, 2017

Registered at 150 PINE FOREST DR, SUITE 160, SHENANDOAH, TX 773845302 (Tel: 8323775846)

✅

NPI Profile Active September 26, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location September 26, 2016

Registered at 13215 DOTSON RD, SUITE 160, HOUSTON, TX 770704535 (Tel: 8323775846)

📍

Updated Business Mailing Address September 26, 2016

Registered at 6 PEBBLE COVE CT, THE WOODLANDS, TX 773813309 (Tel: 8323775846)

👤

Provider Name / Credentials Updated September 26, 2016

Recorded as RAFAEL LUGO, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 26, 2016

Surgery (License #K8309 in TX)

🟢

Initial NPI Registration & Enumeration September 02, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245224492

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 02, 2005

Last Update: August 23, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 131330

Spring, TX 773931330

Phone: 8323775846

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.