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PEDRO SOIBELMANN TETELBOM M.D.
NPI 1346736337
Ophthalmology - Retina Specialist in Little Rock, AR

Active since July 02, 2018PECOS EnrolledAccepts Medicare Assignment
RETINA ASSOCIATES, P.A., 9800 BAPTIST HEALTH DRIVE, SUITE 200, LITTLE ROCK, AR 72205(501) 219-0900(501) 312-4750 Get Directions Write a Review

NPPES record last updated: August 21, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 21, 2024, May 17, 2022, Jul 2, 2018 (3 updates tracked since 2018).

About Pedro Soibelmann Tetelbom M.d. NPPES

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

PEDRO SOIBELMANN TETELBOM M.D. (NPI 1346736337) is an individual retina specialist in Little Rock, Arkansas, licensed in Arkansas (E15207) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1346736337
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NamePEDRO SOIBELMANN TETELBOMCredential: M.D.
Location AddressRETINA ASSOCIATES, P.A., 9800 BAPTIST HEALTH DRIVE, SUITE 200Little Rock, AR 72205-7101
Mailing Address9800 Baptist Health Drive, Suite 200Little Rock, AR 72205-6243 · (501) 219-0900 · Fax (501) 312-4750
Phone(501) 219-0900
Fax(501) 312-4750
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 2, 2018
Last NPPES UpdateAugust 21, 20243 updates tracked since enumeration
NPPES CertifiedMay 17, 2022
✔ NPI 1346736337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in AR · E15207
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License E-15207 (AR)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
RETINA ASSOCIATES, P.A., Little Rock, AR 72205
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Other Identifiers 1

Medicaid285432001AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Pedro Soibelmann Tetelbom 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 ID4082092549
PECOS Enrollment IDI20220613000859
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Pedro Soibelmann Tetelbom reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Arkansas For Medical Sciences
1.7 mi
Psychiatry
4224 SHUFFIELD DR
Little Rock, AR 72205
  • Reassigned Medicare billing, Arkansas enrollment
  • Also billed through NPI 1326341488 (Arkansas)
  • 2,038 clinicians in this Medicare group
NPI 1669188157 (501) 526-8200
Retina Associates, P.A.
2.0 mi
Specialist
9800 LILE DR, SUITE 200
Little Rock, AR 72205
  • Reassigned Medicare billing, Arkansas enrollment
  • 10 clinicians in this Medicare group
NPI 1447215603 (501) 219-0900
Arkansas Childrens Hospital
6.9 mi
Pediatrics
1 CHILDRENS WAY # 664
Little Rock, AR 72202
  • Reassigned Medicare billing, Arkansas enrollment
  • 944 clinicians in this Medicare group
NPI 1598773079 (501) 364-2526

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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.

Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
197 services133 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
126 services72 patients
Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
122 services82 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
110 services110 patients
Injection, bevacizumab, 10 mg J9035
Bevacizumab is a medication given through an injection. It's designed to prevent the growth of new blood vessels that cancer cells need to grow and spread. The 10 mg dose refers to the amount of the drug in the injection.
86 services46 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
68 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72205 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
$119.36 typical visit price
range $51.36 – $157.74
Typical copayment $29.84 (range $12.84 – $39.43)
Most-billed visit code 99204
Established Patient
$64.56 typical visit price
range $16.16 – $128.77
Typical copayment $16.14 (range $4.04 – $32.19)
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.

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 Pedro Soibelmann Tetelbom's NPI number?

The NPI number for Pedro Soibelmann Tetelbom is 1346736337. It was assigned to this individual provider in the NPPES registry on July 2, 2018.

Where is Pedro Soibelmann Tetelbom located?

Pedro Soibelmann Tetelbom practices at Retina Associates, P.A. 9800 Baptist Health Drive, Suite 200, Little Rock, AR 72205. The listed phone number is (501) 219-0900.

What is Pedro Soibelmann Tetelbom's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Pedro Soibelmann Tetelbom enrolled in Medicare?

Yes. Pedro Soibelmann Tetelbom 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.

Which organizations bill Medicare for Pedro Soibelmann Tetelbom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pedro Soibelmann Tetelbom reassigns Medicare benefits to 3 organizations: University Of Arkansas For Medical Sciences (Little Rock, AR), Retina Associates, P.A. (Little Rock, AR) and Arkansas Childrens Hospital (Little Rock, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pedro Soibelmann Tetelbom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pedro Soibelmann Tetelbom accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Pedro Soibelmann Tetelbom 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 Pedro Soibelmann Tetelbom was last updated on August 21, 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.