NPIMap

Individual provider Active NPI

Jose S Padilla Jr., MD

  • Surgery Physician
  • Lebanon, MO
National Provider Identifier
1265449755
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2015008157 Issued in MO
Practice address
120 Hospital Dr
Suite 200
Lebanon, MO 65536-9238
Phone
(417) 533-6780
Fax
(417) 533-6789
NPI assigned
Aug 1, 2006
Last updated
Jul 31, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X N-8118 AR
Surgery Physician 208600000X N8118 AR
Surgery Physician 208600000X 2015008157 MO Primary

Addresses

Primary practice location

120 Hospital Dr
Suite 200
Lebanon, MO 65536-9238

Mailing address

PO Box 505164
Saint Louis, MO 63150-5164
Phone (417) 829-4620

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidMO
120084001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101206000660 AR Practitioner - General Surgery 7416144290 Reassigns benefits to 1 organization
I20150625002335 MO Practitioner - General Surgery 7416144290 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Puerto Rico School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 553-6059

120 Hospital Dr
Lebanon, MO 65536-9227

120 Hospital Dr
Suite 300And350
Lebanon, MO 65536-9238
Phone (417) 533-6746

1605 Martin Springs Dr
Rolla, MO 65401-2980

211 Carter St
Berryville, AR 72616-4303
Phone (870) 423-3338

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy45
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux41
Melanoma (skin cancer) excision1-10
Removal of tissue63
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N8118ARMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Surgery CurrentSince Feb 13, 2018 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 12, 2015 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 7, 2018 Accepting new patients
Advocates for a Healthy Community, Inc CurrentSince Feb 24, 2020 Accepting new patients
Advocates for a Healthy Community Inc CurrentSince Feb 24, 2020 Accepting new patients

Locations

211 Carter St
Berryville, AR 72616
Phone (417) 869-3200

214 Carter St
Berryville, AR 72616
Phone (870) 423-3355

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

120 Hospital Dr
Ste 200
Lebanon, MO 65536
Phone (417) 533-6780

860 Lynn St
Lebanon, MO 65536
Phone (417) 334-8337

100 W US Highway 60
Mountain View, MO 65548
Phone (417) 934-7000

100 W US Highway 60
Ste 2
Mountain View, MO 65548
Phone (417) 934-2251

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

440 E Tampa St
Springfield, MO 65806
Phone (417) 831-0191

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Interoperability endpoints

  • Direct secure messaging: jpadilla286941@directb.mercy.net
  • Direct secure messaging: jpadilla296597@directc.mercy.net
  • Direct secure messaging: jpadilla694580@direct.ochin.org
  • Direct secure messaging: matthew.stinson.d1.p1@direct.jordanvalley.nextgenshare.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1265449755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369238",
            "telephone_number": "417-533-6780",
            "fax_number": "417-533-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "JOSE",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "AR",
            "license": "N-8118",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "N8118",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2015008157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120084001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, MO

Sources for this page

Verify at the official NPI Registry.