MR. JOHN D LEDBETTER D.O.
NPI 1750355004
Family Medicine in San Antonio, TX
NPI Status: Active since February 14, 2006
Contact Information
1303 MCCULLOUGH AVE
STE 135
SAN ANTONIO, TX
ZIP 78212
Phone: (210) 227-9214
Fax: (210) 476-8515
- Individual
- Male
- Years of Experience 29
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About JOHN LEDBETTER
This page provides the complete NPI Profile along with additional information for John Ledbetter, a primary care provider established in San Antonio, Texas with a medical specialization in Family Medicine and more than 29 years of experience. He graduated from University Of North Texas Hsc, College Of Osteopathic Med in 1997. The healthcare provider is registered in the NPI registry with number 1750355004 assigned on February 2006. The practitioner's primary taxonomy code is 207Q00000X with license number K5598 (TX). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1750355004
- Provider Name
- MR. JOHN D LEDBETTER D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1303 MCCULLOUGH AVE STE 135 SAN ANTONIO, TX 78212
- Location Phone
- (210) 227-9214
- Location Fax
- (210) 476-8515
- Mailing Address
- 1303 MCCULLOUGH AVE STE 135 SAN ANTONIO, TX 78212
- Mailing Phone
- (210) 227-9214
- Mailing Fax
- (210) 476-8515
- Medical School Name
- UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
- Graduation Year
- 1997
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-14-2006
- Last Update Date
- 11-12-2009
- Code Navigator
A primary care provider (PCP) like John Ledbetter sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- K5598
- License State
- TX
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
G81381 | MEDICARE UPIN (02) | TX | |
8561K0 | MEDICARE ID-TYPE UNSPECIFIED (04) | TX | |
1358285 | MEDICAID (05) | TX |
Medicare Participation & PECOS Enrollment Status
John Ledbetter is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
John Ledbetter 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), a Home Health Agency (HHA) and Power Mobility Devices.
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
PECOS PAC ID: 6901093087
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20101215000768
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
8 DME suppliers used 25 Medicare Claims 72 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
4 DME suppliers used 12 Medicare Claims 20 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
1 DME suppliers used 12 Medicare Claims 12 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
3 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Wheelchairs (DD000N)
Lightweight wheelchair (HCPCS:K0003)
1 DME suppliers used 13 Medicare Claims 13 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Administration of influenza virus vaccine
Administration of vaccine
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free
Injection of drug or substance under skin or into muscle
Injection, methylprednisolone acetate, 80 mg
Insertion of needle into vein for collection of blood sample
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
This service was performed 53 times for 53 patientsAdministering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.
This service was performed 21 times for 21 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 192 times for 147 patientsThis 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.
This service was performed 229 times for 195 patientsThe quadrivalent influenza vaccine is a flu shot that protects against four different flu viruses. Derived from cell cultures, it is free of preservatives and antibiotics. It's a safe and effective way to reduce your risk of getting the flu.
This service was performed 43 times for 43 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 53 times for 26 patientsMethylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
This service was performed 16 times for 15 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 109 times for 98 patientsAn electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
This service was performed 14 times for 14 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.23 for a new patient copayment and $24.26 for an established patient copayment.
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 78212 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.92
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $21.23
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
Quality Measure | Performance | Number of Patients |
---|---|---|
Colorectal Cancer Screening | 79% | 103 |
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
Pneumococcal Vaccination Status for Older Adults | 72% | 160 |
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 100% | 233 |
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 89% | 141 |
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen |
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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. | |||||||||
1 | 7 | 5 | 0 | 3 | 5 | 5 | 0 | 0 | 4 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 10 | 0 | 6 | 5 | 10 | 0 | 0 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 0 + 0 + 6 + 5 + 1 + 0 + 0 + 0 + 24 = 46 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
50 - 46 = 4 | 4 |
The NPI number 1750355004 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. VICTOR IVAN LYDAY M.D.
Orthopaedic Surgery
(Hand Surgery)
1303 MCCULLOUGH AVE
SUITE 361
SAN ANTONIO, TX
ZIP 78212
DR. JOSE F CAVAZOS M.D.
Family Medicine
(Adult Medicine)
1303 MCCULLOUGH AVE
533
SAN ANTONIO, TX
ZIP 78212
DR. ERIC SCHAFFER MD
Plastic Surgery
1303 MCCULLOUGH AVE
STE 363
SAN ANTONIO, TX
ZIP 78212
MARK A ISAEFF M.D.
Internal Medicine
1303 MCCULLOUGH AVE
SUITE 542
SAN ANTONIO, TX
ZIP 78212
DR. DANIEL A CALDERON M.D.
Obstetrics & Gynecology
1303 MCCULLOUGH AVE
SUITE GL70
SAN ANTONIO, TX
ZIP 78212
DR. ORLANDO J SURIS M.D.
Obstetrics & Gynecology
1303 MCCULLOUGH AVE
SUITE GL70
SAN ANTONIO, TX
ZIP 78212
DR. DOMINGO PADILLA, JR M.D.
Specialist
1303 MCCULLOUGH AVE
SUITE GL70
SAN ANTONIO, TX
ZIP 78212
AMBER GRAPEVINE MS, RD
Dietitian, Registered
1303 MCCULLOUGH AVE
SUITE GL 70
SAN ANTONIO, TX
ZIP 78212
DR. JAMES HAROLD VERNIER M.D.
Anesthesiology
1303 MCCULLOUGH AVE
SUITE 229
SAN ANTONIO, TX
ZIP 78212
DR. HAROLD G. FELTER M.D.
Internal Medicine
(Cardiovascular Disease)
1303 MCCULLOUGH AVE
SUITE 300
SAN ANTONIO, TX
ZIP 78212
JOHN J DELEON JR. M.D.
Urology
1303 MCCULLOUGH AVE
SUITE 166
SAN ANTONIO, TX
ZIP 78212
DR. ROBERT JAY MAGNON M.D.
Dermatology
1303 MCCULLOUGH AVE
SUITE 525
SAN ANTONIO, TX
ZIP 78212
MICHELLE PATIN FOOTE M.D.
Obstetrics & Gynecology
1303 MCCULLOUGH AVE
GL70
SAN ANTONIO, TX
ZIP 78212
DR. JEANNIE ALLYSON BAQUERO M.D.
Internal Medicine
(Endocrinology, Diabetes & Metabolism)
1303 MCCULLOUGH AVE
SUITE 374
SAN ANTONIO, TX
ZIP 78212
NEERA BHATIA MD
Obstetrics & Gynecology
1303 MCCULLOUGH AVE
#237
SAN ANTONIO, TX
ZIP 78212
DR. JOHN E. ETLINGER M.D.
Surgery
1303 MCCULLOUGH AVE
SUITE 235
SAN ANTONIO, TX
ZIP 78212
DR. MARVIN SAM BELASCO M.D.
Specialist
1303 MCCULLOUGH AVE
125
SAN ANTONIO, TX
ZIP 78212
O'NEILL & ASSOCIATES P.A.
Specialist
1303 MCCULLOUGH AVE
125
SAN ANTONIO, TX
ZIP 78212
DONALD LENOIR MD
Anesthesiology
1303 MCCULLOUGH AVE
SUITE 229
SAN ANTONIO, TX
ZIP 78212
BOYCE B. OLIVER M.D.
Surgery
1303 MCCULLOUGH AVE
SUITE 235
SAN ANTONIO, TX
ZIP 78212
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750355004, enumerated as an "individual" on February 14, 2006.
The provider is located at 1303 MCCULLOUGH AVE STE 135 SAN ANTONIO, TX 78212 and the phone number is (210) 227-9214.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Aetna CVS Health, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.