DR. RANDOLPH A IBARRA DDS
NPI 1003878034
Dentist - General Practice in San Antonio, TX

Q: What is Randolph Ibarra's NPI number?

The NPI number for Randolph Ibarra is 1003878034. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Q: What is Randolph Ibarra's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Randolph Ibarra was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since April 05, 2006PECOS Enrolled

8744 GRISSOM RD, SAN ANTONIO, TX 78251(210) 523-0000(210) 523-0067 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Randolph A Ibarra Dds NPPES

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

DR. RANDOLPH A IBARRA DDS (NPI 1003878034) is an individual general practice provider in San Antonio, Texas, licensed in Texas (14645) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003878034

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. RANDOLPH A IBARRACredential: DDS

Location Address8744 GRISSOM RDSan Antonio, TX 78251-4819

Mailing Address8355 Crestway Dr, 1126Converse, TX 78109-3596 · (210) 623-6112

Phone(210) 523-0000

Fax(210) 523-0067

Sole ProprietorYes

Enumeration DateApril 5, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1003878034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in TX · 14645

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

8744 GRISSOM RD, San Antonio, TX 78251

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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 (PECOS)

Dr. Randolph A Ibarra Dds 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 78251 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

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

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

THOMAS R WATKINS,DDS AND ASSOCIATES

Dentist (General Practice)

8744 GRISSOM RD
SAN ANTONIO, TX 78251

Bexar County (210) 523-0000

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 Randolph Ibarra's NPI number?

The NPI number for Randolph Ibarra is 1003878034. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Where is Randolph Ibarra located?

Randolph Ibarra practices at 8744 Grissom Rd, San Antonio, TX 78251. The listed phone number is (210) 523-0000.

What is Randolph Ibarra's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Randolph Ibarra enrolled in Medicare?

Yes. Randolph Ibarra is registered in the Medicare PECOS enrollment system.

What insurance does Randolph Ibarra accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and Ambetter from Superior HealthPlan and 17 other insurers list Randolph Ibarra 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.

When was this NPI record last updated?

The NPPES record for Randolph Ibarra was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.