Rudrick Villoso Ledesma, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

Q7224 Issued in TX

Practice address

1133 Medical Dr
Tyler, TX 75701-2130

Phone

(903) 595-5486

Fax

(903) 595-5128

NPI assigned

Aug 15, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tyler Nephrology Associates PAGroup PAC ID 6901862242, 27 clinicians

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jacksonville Dialysis Center Dialysis facility, Jacksonville, TX, CCN 452859
• Renal Care Group - Gilmer Dialysis facility, Gilmer, TX, CCN 452891
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
• Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rledesma32255@direct.acumenmd.com
• Direct secure messaging: rledesma355419@ahs.direct-ci.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group NPD
• Tyler Nephrology Associates, P.a.

  • Nephrology Physician
  • Tyler, TX
  • NPI 1942360326
  Medicare reassignment Care Compare group NPD
• Etmc Physician Group Inc.

  • Rural Health Clinic/Center
  • Chandler, TX
  • NPI 1235706581
  NPD

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

• RCG East Texas, LLP

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jacksonville, TX
  • NPI 1386756260

  Dialysis facility

  Care Compare affiliation Name & address match
• Renal Care Group Texas, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Gilmer, TX
  • NPI 1386746568

  Dialysis facility

  Care Compare affiliation Name & address match
• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Jacksonville Hospital LLC

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Mother Frances Hospital Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1306125836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 Nacogdoches St Ste 240",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "TX",
            "postal_code": "757662465",
            "country_code": "US",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1336 S Palestine St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "TX",
            "postal_code": "757513621",
            "country_code": "US",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4002 S Loop 256 Ste R",
            "address_purpose": "LOCATION",
            "city": "Palestine",
            "state": "TX",
            "postal_code": "758018498",
            "country_code": "US",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "RUDRICK",
        "middle_name": "VILLOSO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OK",
            "license": "33999",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "Q7224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360894501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200653260A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Learned, PT
• Learning About Family
• Nancy Leatherwood
• Steve Wayne Lebo, D,D.S.
• Michelle Sharon Esclares Ledesma, MD
• Sommer Long Ledkins
• Albert Lee, MD
• Albert C Lee, MD
• Alexus Lee
• Alicia Lee

• Nephrology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.