JOHN PEROUTKA
NPI 1659484558
Dentist - General Practice in Midlothian, VA

Active since August 16, 2006Opted out of Medicare · through Sep 10, 2027
13321 MIDLOTHIAN TPKE STE C, MIDLOTHIAN, VA 23113(804) 794-5304 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About John Peroutka NPPES

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

JOHN PEROUTKA (NPI 1659484558) is an individual general practice provider in Midlothian, Virginia, licensed in Virginia (0401410896) and active in the NPI registry since August 2006. He has opted out of Medicare through September 10, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1659484558
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJOHN PEROUTKA
Location Address13321 MIDLOTHIAN TPKE STE CMidlothian, VA 23113-4270
Mailing Address3614 Hawthorne AveRichmond, VA 23222-1824
Sole ProprietorYes
Enumeration DateAugust 16, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1659484558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in VA · 0401410896
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.
13321 MIDLOTHIAN TPKE STE C, Midlothian, VA 23113

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

John Peroutka has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 10, 2015 through September 10, 2027.

Opt-Out Effective DateSeptember 10, 2015
Opt-Out In Effect ThroughSeptember 10, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23113 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
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 John Peroutka's NPI number?

The NPI number for John Peroutka is 1659484558. It was assigned to this individual provider in the NPPES registry on August 16, 2006.

Where is John Peroutka located?

John Peroutka practices at 13321 Midlothian Tpke Ste C, Midlothian, VA 23113. The listed phone number is (804) 794-5304.

What is John Peroutka's specialty?

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

Is John Peroutka enrolled in Medicare?

No. John Peroutka has opted out of Medicare through September 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does John Peroutka accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list John Peroutka 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 John Peroutka 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.