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ANTONIO PEDRO M.D.
NPI 1922192434
Internal Medicine - Nephrology in Laurel, DE

Active since October 02, 2006PECOS EnrolledAccepts Medicare Assignment
62.02/100
CMS Quality Rating
1124 SOUTH CENTRAL AVE, LAUREL, DE 19956(302) 875-7753(302) 875-7966 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Antonio Pedro M.d. NPPES

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

ANTONIO PEDRO M.D. (NPI 1922192434) is an individual nephrology provider in Laurel, Delaware, licensed in Delaware (C1-0004999) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Tidalhealth Peninsula Regional, Inc, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1922192434
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameANTONIO PEDROCredential: M.D.
Location Address1124 SOUTH CENTRAL AVELaurel, DE 19956
Mailing Address66 River's End DriveSeaford, DE 19973 · (302) 628-3018
Phone(302) 875-7753
Fax(302) 875-7966
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateOctober 2, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1922192434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in DE · C1-0004999
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
1124 SOUTH CENTRAL AVE, Laurel, DE 19956
Open in Google Maps ↗

Other Identifiers 1

Medicare UPING43047

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Antonio Pedro 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 ID7618932542
PECOS Enrollment IDI20041119000798
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.

Areas of Expertise CMS Part B claims 9

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 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.
422 services201 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
333 services100 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
206 services22 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.
95 services78 patients
Home dialysis services per month (20 years or older) 90966
Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.
86 services11 patients
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.
61 services55 patients

Hospital Affiliations CMS Care Compare

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

Tidalhealth Peninsula Regional, Inc

Acute Care Hospitals · Salisbury, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210019
Location100 East Carroll AvenueSalisbury, MD 21801 · Wicomico County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19956 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
$131.15 typical visit price
range $57.12 – $173.08
Typical copayment $32.78 (range $14.28 – $43.27)
Most-billed visit code 99204
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
Most-billed visit code 99214
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.

62.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.03
Promoting Interoperability0
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix B4197
Other-Enteral and Parenteral · category OB005N
1 supplier28 claims84 services$278.73 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
1 supplier28 claims84 services$7.98 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
1 supplier28 claims84 services$24.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ODILON CLARAVALL M.D.
Internal Medicine
1124 SOUTH CENTRAL AVE
LAUREL, DE 19956
Sussex County (302) 875-7753

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 Antonio Pedro's NPI number?

The NPI number for Antonio Pedro is 1922192434. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Antonio Pedro located?

Antonio Pedro practices at 1124 South Central Ave, Laurel, DE 19956. The listed phone number is (302) 875-7753.

What is Antonio Pedro's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Antonio Pedro enrolled in Medicare?

Yes. Antonio Pedro 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.

What insurance does Antonio Pedro accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Antonio Pedro 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 Antonio Pedro affiliated with any hospitals?

According to CMS data, Antonio Pedro is affiliated with Tidalhealth Peninsula Regional, Inc.

When was this NPI record last updated?

The NPPES record for Antonio Pedro 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.