Individual provider Active NPI

Michael Robert Ledoux, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1790223568
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10969 Issued in TX
Practice address
2829 Babcock Rd
Suite 700
San Antonio, TX 78229-6028
Phone
(210) 593-1485
Fax
(210) 804-5418
NPI assigned
Feb 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10969 TX Primary

Addresses

Primary practice location

2829 Babcock Rd
Suite 700
San Antonio, TX 78229-6028

Mailing address

400 Concord Plaza Dr
Suite 300
San Antonio, TX 78216-6905
Phone (210) 804-5416

Other identifiers 1

IdentifierTypeStateIssuer
PA10969OtherTXTEXAS MEDICAL BOARD

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170327001140 TX Practitioner - Physician Assistant 3476838822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The San Antonio Orthopaedic Group LLPGroup PAC ID 6800798794, 143 clinicians

Practice addresses (Care Compare)

19138 US Hwy 281 N
San Antonio, TX 78258-4988
Phone (210) 804-5400

400 Concord Plaza Dr
Suite 300
San Antonio, TX 78216-6991
Phone (210) 804-5400

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

Merit-based Incentive Payment System (MIPS)

Final score
79.86 of 100Reported as group
Quality
65.93
Promoting interoperability
94
Improvement activities
40
Cost
71.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The San Antonio Orthopaedic Group, LLP CurrentSince Jan 22, 2017 Accepting new patients
The San Antonio Orthopaedic Group, LLP CurrentSince Jan 22, 2017 Accepting new patients
Trinity Regional Medical Center Past Accepting new patients

Locations

400 Concord Plaza Dr
Ste 300
San Antonio, TX 78216
Phone (210) 804-5416

2829 Babcock Rd
Ste 700
San Antonio, TX 78229
Phone (210) 396-5270

1200 Brooklyn Ave
Ste 320
San Antonio, TX 78212
Phone (210) 225-5741

19138 US Highway 281 N
Ste 100
San Antonio, TX 78258
Phone (210) 593-1435

Interoperability endpoints

  • Direct secure messaging: michael.ledoux.1@94.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1790223568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CONCORD PLAZA DR",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166905",
            "telephone_number": "210-804-5416",
            "fax_number": "210-678-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 BABCOCK RD",
            "address_2": "SUITE 700",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296028",
            "telephone_number": "210-593-1485",
            "fax_number": "210-804-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDOUX",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA10969",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.