Logan Ledbetter, RD, CNSC is a medicare enrolled "Physician Assistant" provider in Roseville, California. He went to Loma Linda University School Of Medicine and graduated in 2020 and has 6 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Eric L Ellis Md Inc, Sutter Valley Medical Foundation and his current practice location is
3 Medical Plaza Dr, Roseville, California. You can reach out to his office (for appointments etc.) via phone at
(916) 774-8885.
Logan Ledbetter is licensed to practice in California (license number 1178331) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1457883068.
Healthcare Provider's Profile
| Full Name | Logan Ledbetter |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 6 Years |
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| Location | 3 Medical Plaza Dr, Roseville, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Logan Ledbetter attended and graduated from Loma Linda University School Of Medicine in 2020
NPI Data:
- NPI Number: 1457883068
- Provider Enumeration Date: 04/02/2017
- Last Update Date: 03/05/2025
Medicare PECOS Information:
- PECOS PAC ID: 0446627913
- Enrollment ID: I20221114001261
Medical Identifiers
Medical identifiers for Logan Ledbetter such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457883068 | NPI | - | NPPES |
| 1457883068 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 86006556 (California) | Secondary |
| 363A00000X | Physician Assistant | 1178331 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Eric L Ellis Md Inc | 9032458815 | 15 |
| Sutter Valley Medical Foundation | 9830094515 | 2136 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Logan Ledbetter is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Logan Ledbetter, RD, CNSC
Po Box 255228,
Sacramento, CA 95865-5228
Ph: () - | Logan Ledbetter, RD, CNSC
3 Medical Plaza Dr,
Roseville, CA 95661-3087
Ph: (916) 774-8885 |
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