Balaishe Boakai Ballo

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

26NJ15034400 Issued in NJ

Practice address

1600 Haddon Ave FL 3
Camden, NJ 08103-3101

Phone

(856) 988-6260

Fax

(856) 988-6270

NPI assigned

Feb 26, 2024

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

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515

  NJ, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Mid-Atlantic Anesthesia Associates PA

  • Anesthesiology Physician
  • Camden, NJ
  • NPI 1366486508

  NJ

  Medicare reassignment NPD
• Associates in Anesthesia, Inc.

  • Anesthesiology Physician
  • Chadds Ford, PA
  • NPI 1942281191

  PA

  Medicare reassignment NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988
  Care Compare group NPD
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Moorestown, NJ
  • NPI 1134813850
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Somers Point, NJ
  • NPI 1174130322
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Vineland, NJ
  • NPI 1275217440
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Hand Surgery Physician
  • Voorhees, NJ
  • NPI 1316368012
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Cherry Hill, NJ
  • NPI 1427740083
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Sewell, NJ
  • NPI 1508653668
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Sewell, NJ
  • NPI 1669156980
  Care Compare group
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Bordentown, NJ
  • NPI 1780373803
  Care Compare group

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

• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024

  Hospital

  Care Compare affiliation

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virtua Medical Group, PA 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1003672346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HADDON AVE FL 3",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081033101",
            "telephone_number": "856-988-6260",
            "fax_number": "856-988-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Haddon Ave",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "856-757-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLO",
        "first_name": "BALAISHE",
        "middle_name": "BOAKAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "147728",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ15034400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Marie Baldwin
• Konstantinos Balis, MD
• Amy Balko, PSY.D.
• Leonora M Ball, APN-C
• Laurel L. Ballentine, FNP
• Gianna Ballon, M.D.
• Ahmad Ballout, MD
• Bailey Balouch, MD
• Michael A Bamimore, DO
• Mark Bampton, OD

• All providers in Camden, NJ
• Certified Registered Nurse Anesthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.