Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Raphael Omoto, CNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1245939495

Mr. Raphael Omoto, CNP is a Nurse Practitioner in Minneapolis, Minnesota. Qualified in 2022, 4 years ago. Practices with Hennepin County, a 132-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2023
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

2215 E Lake St
Minneapolis, MN 55407-4385
Phone: (612) 596-9438
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 9968 (MN)

Record details

NPI number1245939495
Entity typeIndividual (Type 1)
GenderMale
Credentials CNP
Sole proprietorYes
NPI enumeratedFebruary 27, 2023
Last updated in NPPESApril 2, 2026
Certification dateApril 2, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Hennepin County — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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