MR. RONALD A. CARTER D.D.S.
NPI 1396807269
Dentist - General Practice in Los Banos, CA

NPI Status: Active since December 15, 2006

Contact Information

400 W I ST
LOS BANOS, CA
ZIP 93635
Phone: (209) 826-5732
Fax: (209) 826-2469

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  • Individual
  • Male
  • Dentist
  • General Practice
  • PECOS Enrolled

About RONALD CARTER

Ronald Carter is a provider established in Los Banos, California and his medical specialization is Dentist with a focus in general practice . The healthcare provider is registered in the NPI registry with number 1396807269 assigned on December 2006. The practitioner's primary taxonomy code is 1223G0001X with license number 17045 (CA). The provider is registered as an individual and his NPI record was last updated 17 years ago.

NPI
1396807269
Provider Name
MR. RONALD A. CARTER D.D.S.
Gender
Male
Entity Type
Individual
Location Address
400 W I ST LOS BANOS, CA 93635
Location Phone
(209) 826-5732
Location Fax
(209) 826-2469
Mailing Address
400 W I ST LOS BANOS, CA 93635
Mailing Phone
(209) 826-5732
Mailing Fax
(209) 826-2469
Is Sole Proprietor?
Yes
Enumeration Date
12-15-2006
Last Update Date
07-08-2007
Code Navigator

A dentist like Ronald Carter is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
License No.
17045
License State
CA
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Florida Combined Life

    • BlueDental Copayment Q - PPO
    • BlueDental Copayment QF - PPO
  • Humana

    • Humana Dental Smart Choice - PPO
    • Humana Dental Smart Choice - High - PPO
    • Humana Dental Smart Choice - Lite - PPO
    • Humana Dental Smart Choice - Low - PPO
    • Humana Dental Smart Choice Basic - PPO
    • Humana Dental Smart Choice- Lite - PPO
  • UnitedHealthcare

    • Smile Now Arizona - No Waiting Period PPO - PPO
    • Smile Now Illinois - No Waiting Period PPO - PPO
    • Smile Now Michigan - No Waiting Period PPO - PPO
    • Smile Now Ohio - No Waiting Period PPO - PPO
    • Smile Now Texas- No Waiting Period PPO - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

PECOS Enrollment and Medicare Participation Status

Ronald Carter is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 93635 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $93.25
  • Minimum New Patient Price $60.86
  • Maximum New Patient Price $183.39
  • Average New Patient Copayment $23.31
  • Minimum New Patient Copayment $15.21
  • Maximum New Patient Copayment $45.84

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $76.09
  • Minimum Established Patient Price $19.29
  • Maximum Established Patient Price $150.36
  • Average Established Patient Copayment $19.02
  • Minimum Established Patient Copayment $4.82
  • Maximum Established Patient Copayment $37.59

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for MR. RONALD A. CARTER D.D.S.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1396807269
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2318616014212
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 8 + 6 + 1 + 6 + 0 + 1 + 4 + 2 + 1 + 2 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1396807269 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1821270844MRS. LIGAYA D SANTOS FNP
Individual
Family Medicine400 W I ST SUITE C
LOS BANOS, CA 93635
(209) 710-6333
1306372198KD MEDICAL GROUP INC
Organization
Podiatrist400 W I ST SUITE C
LOS BANOS, CA 93635
(209) 827-2766
1144437187RONALD A. CARTER D.D.S. INC.
Organization
Dentist (General Practice)400 W I ST
LOS BANOS, CA 93635
(209) 826-5732
1992178578ADVANCED AMBULATORY SURGERY CENTER
Organization
Clinic/Center (Ambulatory Surgical)400 W I ST SUITE E
LOS BANOS, CA 93635
(209) 489-9110
1346223757 NAITTE P. JORDAN FNP
Individual
Nurse Practitioner400 W I ST
LOS BANOS, CA 93635
(209) 826-0195

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396807269, enumerated in the NPI registry as an "individual" on December 15, 2006

The provider is located at 400 W I St Los Banos, Ca 93635 and the phone number is (209) 826-5732

The provider's speciality is Dentist with taxonomy code 1223G0001X with a focus in General Practice

The provider might be accepting Accepts: Florida Combined Life, Humana and UnitedHealthcare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of July 02, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Medicare beneficiaries should expect a typical cost of $93.25 with an average copayment of $23.31 for new patient appointments. Established patients should expect a typical charge of $76.09 and an average copayment of 19.02. Please review your insurance plan or contact the provider directly to determine your specific costs.

This NPI record was last updated on December 15, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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