Individual provider Active NPI

Ramon Luis Caballero, MD

  • Urology Physician
  • Lexington, KY
National Provider Identifier
1851480453
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
32238 Issued in KY
Practice address
1101 Veterans Dr
Lexington, KY 40502-2235
Phone
(859) 233-4511
NPI assigned
Oct 12, 2006
Last updated
Mar 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 32238 KY Primary

Addresses

Primary practice location

1101 Veterans Dr
Lexington, KY 40502-2235

Mailing address

PO Box 69
1138 Lexington Road Suite 110
Georgetown, KY 40324
Phone (502) 868-7666

Other identifiers 1

IdentifierTypeStateIssuer
6432231MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161121002128 GA Practitioner - Urology 6901798263 Reassigns benefits to 1 organization
I20230523000032 MS Practitioner - Urology 6901798263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Perelman School of Med at the University of Pennsylvania, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vicksburg Clinic LLCGroup PAC ID 5890696330, 27 clinicians

Practice addresses (Care Compare)

2100 Hwy 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5000

2200 Hwy 61 N
Vicksburg, MS 39183-8246

348 Crossgates Blvd
Suite 1200
Brandon, MS 39042-2701
Phone (601) 883-6092

350 Crossgates Blvd
Brandon, MS 39042-2601
Phone (601) 883-6092

46 SGT Prentiss Dr
Natchez, MS 39120-4792
Phone (601) 883-5858

54 Sergeant Prentiss Dr
Natchez, MS 39120-4726
Phone (601) 883-5858

54 SGT Prentiss Dr
Suite 103
Natchez, MS 39120-4726
Phone (601) 883-5858

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Prostate resection33
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32238KYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia CurrentSince Jan 1, 2022 Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Jan 1, 2022 Accepting new patients
Vicksburg Clinic LLC CurrentSince Apr 17, 2023 Accepting new patients
Vicksburg Clinic LLC Urology Past Accepting new patients
Vicksburg Clinic LLC Urology Past Accepting new patients

Locations

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

54 Sgt Prentiss Dr
Natchez, MS 39120
Phone (601) 443-2100

104 McAuley Dr
Vicksburg, MS 39183
Phone (601) 638-7271

Interoperability endpoints

  • Direct secure messaging: ramon.caballero.1@1475.direct.athenahealth.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 3

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1851480453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "address_2": "1138 LEXINGTON ROAD SUITE 110",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "40324",
            "telephone_number": "502-868-7666",
            "fax_number": "502-868-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 VETERANS DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022235",
            "telephone_number": "859-233-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALLERO",
        "first_name": "RAMON",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "32238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6432231",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.