MR. RAMON LUIS CABALLERO MD
NPI 1851480453
Urology in Lexington, KY

Q: What is Ramon Caballero's NPI number?

The NPI number for Ramon Caballero is 1851480453. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Q: What is Ramon Caballero's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Ramon Caballero was last updated on March 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 October 12, 2006PECOS EnrolledAccepts Medicare Assignment

89.76/100

CMS Quality Rating

1101 VETERANS DR, LEXINGTON, KY 40502(859) 233-4511 Get Directions Write a Review

NPPES record last updated: March 10, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 10, 2022, Feb 17, 2022 (2 updates tracked since 2022).

On this page

About Mr. Ramon Luis Caballero Md NPPES

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

MR. RAMON LUIS CABALLERO MD (NPI 1851480453) is an individual urology provider in Lexington, Kentucky, licensed in Kentucky (32238) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Merit Health River Region, and is a graduate of Perelman School Of Med At The University Of Pennsylvania (1986).

NPPES Registry Identity

NPI1851480453

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMR. RAMON LUIS CABALLEROCredential: MD

Location Address1101 VETERANS DRLexington, KY 40502-2235

Mailing AddressPo Box 69, 1138 Lexington Road Suite 110Georgetown, KY 40324 · (502) 868-7666 · Fax (502) 868-8060

Phone(859) 233-4511

Sole ProprietorYes

Medical School CMSPerelman School Of Med At The University Of PennsylvaniaGraduated 1986

Enumeration DateOctober 12, 2006

Last NPPES UpdateMarch 10, 20222 updates tracked since enumeration

NPPES CertifiedMarch 10, 2022

✔ NPI 1851480453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in KY · 32238

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

1101 VETERANS DR, Lexington, KY 40502

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Other Identifiers 1

Medicaid6432231KY

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 Health 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

Mr. Ramon Luis Caballero Md 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 ID6901798263

PECOS Enrollment IDI20230523000032

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

Medicare enrollment records show Ramon Caballero reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospital Authority Of Valdosta And Lowndes County, Georgia

476 mi

Clinic/Center

603 E DENNIS AVE
Nashville, GA 31639

Reassigned Medicare billing, Georgia enrollment
112 clinicians in this Medicare group

NPI 1447591649 (229) 686-2096

Vicksburg Clinic LLC

529 mi

Family Medicine

2100 HIGHWAY 61 N
Vicksburg, MS 39183

Reassigned Medicare billing, Mississippi enrollment
41 clinicians in this Medicare group

NPI 1790711158 (601) 883-5000

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 19

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This 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.

295 services191 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

166 services111 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.

127 services83 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

121 services121 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

66 services62 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

57 services44 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

52 services49 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.

41 services41 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

31 services26 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

30 services30 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

28 services27 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

25 services25 patients

Simple measurement of pressure of urine flow in bladder 51725

This procedure measures the strength of your urine flow. A small, soft tube is gently placed into your body to reach the bladder. It records the pressure while you empty your bladder. It helps check if there are any blockages or issues with bladder control.

24 services23 patients

Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope 52310

This is a procedure to remove an object, stone, or tube from your urinary tract. An endoscope, a thin, flexible tube with a light and camera, is used to locate and remove the object. It is a safe and effective way to address the issue.

23 services22 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

23 services22 patients

Complete laser vaporization of prostate including control of bleeding using an endoscope 52648

This procedure involves using a special light instrument to carefully remove tissue from a gland located in the lower body. This helps improve the flow of body fluids. The process is done through a tube-like device and also controls any bleeding.

21 services21 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

21 services18 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

17 services15 patients

Diagnostic exam of bladder, urethra, and ureter or kidney using an endoscope 52351

This is a procedure where a small tube with a camera, called an endoscope, is used to examine the bladder and the tubes that carry urine from the kidneys to the bladder. It helps in detecting any abnormalities or issues.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Merit Health River Region

Acute Care Hospitals · Vicksburg, MS

2/5 CMS rating

OwnershipProprietary

CMS Certification Number250031

Location2100 Hwy 61 NVicksburg, MS 39183 · Warren County

Emergency services Birthing friendly

Crossgates River Oaks Hospital

Acute Care Hospitals · Brandon, MS

2/5 CMS rating

OwnershipProprietary

CMS Certification Number250096

Location350 Crossgates BlvdBrandon, MS 39042 · Rankin County

Emergency services

Merit Health River Oaks

Acute Care Hospitals · Flowood, MS

1/5 CMS rating

OwnershipProprietary

CMS Certification Number250138

Location1030 River Oaks DriveFlowood, MS 39232 · Rankin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40502 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.76/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

75.59

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

46%932 patients2/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%3,601 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

96%2,756 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

22%203 patients2/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%969 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

55%2,262 patients3/55-star benchmark: 97%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 98% · 1,378 patients

Patients tobacco: 1% · 78 patients

78%896 patients4/55-star benchmark: 98%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

53%896 patients3/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%2,262 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

19%2,262 patients1/55-star benchmark: 89%

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

75%276 patients4/55-star benchmark: 100%

Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months

58%171 patients

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

32%2,262 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

DR. TERESA CONNEALY GERMAN PHARMD

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 281-3939

MR. ADAM LYNN SPENCER

Social Worker (Clinical)

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 233-4511

MS. SHERRI DENISE SAWYERS CSW

Social Worker

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 233-4511

MRS. KATHY J LOVELL RPH

Pharmacist

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 281-4976

MR. JAMES C. MOORE LCSW

Social Worker (Clinical)

1101 VETERANS DR, 29-1-LD
LEXINGTON, KY 40502

Fayette County (859) 281-3949

TRISTAN ALEXANDER CARNES PHARMD

Pharmacist

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 233-4511

JANICE STEPHENS RN

Registered Nurse

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 233-4511

MRS. ANGELINA D FLEMING MSW; LCSW

Social Worker (Clinical)

1101 VETERANS DR
LEXINGTON, KY 40502

Fayette County (859) 233-4511

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 Ramon Caballero's NPI number?

The NPI number for Ramon Caballero is 1851480453. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is Ramon Caballero located?

Ramon Caballero practices at 1101 Veterans Dr, Lexington, KY 40502. The listed phone number is (859) 233-4511.

What is Ramon Caballero's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Ramon Caballero enrolled in Medicare?

Yes. Ramon Caballero 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 Ramon Caballero's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ramon Caballero reassigns Medicare benefits to 2 organizations: Hospital Authority Of Valdosta And Lowndes County, Georgia (Nashville, GA) and Vicksburg Clinic LLC (Vicksburg, MS). 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 Ramon Caballero's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ramon Caballero accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 2 other insurers list Ramon Caballero 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.

Is Ramon Caballero affiliated with any hospitals?

According to CMS data, Ramon Caballero is affiliated with Merit Health River Region, Crossgates River Oaks Hospital and Merit Health River Oaks.

When was this NPI record last updated?

The NPPES record for Ramon Caballero was last updated on March 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.