RUDRICK VILLOSO LEDESMA M.D.
NPI 1306125836
Internal Medicine - Nephrology in Tyler, TX

Q: What is Rudrick Ledesma's NPI number?

The NPI number for Rudrick Ledesma is 1306125836. It was assigned to this individual provider in the NPPES registry on August 15, 2011.

Q: What is Rudrick Ledesma's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Rudrick Ledesma was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 August 15, 2011PECOS EnrolledAccepts Medicare Assignment

1133 MEDICAL DR, TYLER, TX 75701(903) 595-5486(903) 595-5128 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 29, 2017, Nov 8, 2017 (2 updates tracked since 2017).

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About Rudrick Villoso Ledesma M.d. NPPES

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

RUDRICK VILLOSO LEDESMA M.D. (NPI 1306125836) is an individual nephrology provider in Tyler, Texas, licensed in Texas (Q7224) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1306125836

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameRUDRICK VILLOSO LEDESMACredential: M.D.

Location Address1133 MEDICAL DRTyler, TX 75701-2130

Mailing Address1133 Medical DrTyler, TX 75701-2130 · (903) 595-5486 · Fax (903) 595-5128

Phone(903) 595-5486

Fax(903) 595-5128

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateAugust 15, 2011

Last NPPES UpdateApril 20, 20232 updates tracked since enumeration

NPPES CertifiedApril 20, 2023

✔ NPI 1306125836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Licenses✔ Licensed in TX · Q7224✔ Licensed in OK · 33999

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1133 MEDICAL DR, Tyler, TX 75701

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Secondary Practice Locations 3

Location 14002 S Loop 256 Ste RPalestine, TX 75801-8498 · Phone (903) 595-5486 · Fax (903) 595-5128

Location 2203 Nacogdoches St Ste 240Jacksonville, TX 75766-2465 · Phone (903) 595-5486 · Fax (903) 595-5128

Location 31336 S Palestine StAthens, TX 75751-3621 · Phone (903) 595-5486 · Fax (903) 595-5128

Other Identifiers 2

Medicaid360894501TX

Medicaid200653260AOK

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 and accepts Medicare assignment

Rudrick Villoso Ledesma M.d. 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 ID2668764820

PECOS Enrollment IDI20160707002403

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 9

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 hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

659 services175 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

298 services231 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

284 services118 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

84 services55 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

80 services47 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

72 services70 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX

1/5 CMS rating

OwnershipProprietary

CMS Certification Number450083

Location1000 South Beckham AveTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Christus Mother Frances Hospital

Acute Care Hospitals · Tyler, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450102

Location800 East DawsonTyler, TX 75701 · Smith County

Emergency services Birthing friendly

Ut Health East Texas Jacksonville Hospital

Acute Care Hospitals · Jacksonville, TX

OwnershipProprietary

CMS Certification Number450194

Location501 S RagsdaleJacksonville, TX 75766 · Cherokee County

Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450389

Location2000 South Palestine StAthens, TX 75751 · Henderson County

Emergency services Birthing friendly

Christus Mother Frances Hospital- Jacksonville

Critical Access Hospitals · Jacksonville, TX

OwnershipVoluntary non-profit - Private

CMS Certification Number451319

Location2026 S Jackson StreetJacksonville, TX 75766 · Cherokee County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75701 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg J7508

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers22 claims25,800 services$0.40 avg. paid by Medicare

Prednisone, immediate release or delayed release, oral, 1 mg J7512

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers19 claims2,850 services$0.01 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims2,640 services$1.00 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

3 suppliers21 claims21 services$18.97 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

4 suppliers35 claims37 services$12.65 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

IFEATU UCHENNA OTI MD

Internal Medicine (Nephrology)