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TON QUANG LE NP
NPI 1225689359
Nurse Practitioner - Psychiatric/Mental Health in Hilliard, OH

Active since September 20, 2019PECOS EnrolledAccepts Medicare Assignment
3958 BROWN PARK DR, HILLIARD, OH 43026(260) 483-9081 Get Directions Write a Review

NPPES record last updated: February 12, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 2, 2023, Dec 21, 2022, Nov 21, 2022 and 1 more (4 updates tracked since 2019).

About Ton Quang Le Np NPPES

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

TON QUANG LE NP (NPI 1225689359) is an individual psychiatric/mental health provider in Hilliard, Ohio, licensed in Ohio (APRN.CNP.0032598) and active in the NPI registry since September 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1225689359
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameTON QUANG LECredential: NP
Location Address3958 BROWN PARK DRHilliard, OH 43026-1160
Mailing AddressPo Box 392552Pittsburgh, PA 15251-9552 · (512) 792-4402
Phone(260) 483-9081
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 20, 2019
Last NPPES UpdateFebruary 12, 20244 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2024
✔ NPI 1225689359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in OH · APRN.CNP.0032598
3958 BROWN PARK DR, Hilliard, OH 43026
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual 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

Ton Quang Le Np 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 ID9133598600
PECOS Enrollment IDI20221206002104
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 12

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 nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
1,683 services464 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
1,200 services209 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
1,025 services276 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
636 services148 patients
Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
128 services50 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
94 services94 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43026 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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

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

KAREN WEIMAN, LLC
Social Worker (Clinical)
3958 BROWN PARK DR
HILLIARD, OH 43026
Franklin County (614) 581-2029

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 Ton Le's NPI number?

The NPI number for Ton Le is 1225689359. It was assigned to this individual provider in the NPPES registry on September 20, 2019.

Where is Ton Le located?

Ton Le practices at 3958 Brown Park Dr, Hilliard, OH 43026. The listed phone number is (260) 483-9081.

What is Ton Le's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Ton Le enrolled in Medicare?

Yes. Ton Le 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 Ton Le accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 3 other insurers list Ton Le 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 Ton Le was last updated on February 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.