Michael B Balthaser, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036512 Issued in PA

Practice address

1075 Berkshire Blvd
Suite 950
Wyomissing, PA 19610-1264

Phone

(610) 678-2175

Fax

(610) 678-2547

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Cardiology Medical Associates PC

  • Cardiovascular Disease Physician
  • Philadelphia, PA
  • NPI 1205949955
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1013098409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD",
            "address_2": "SUITE 950",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101264",
            "telephone_number": "610-678-2175",
            "fax_number": "610-678-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD",
            "address_2": "SUITE 950",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101264",
            "telephone_number": "610-678-2175",
            "fax_number": "610-678-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTHASER",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Babecki
• Lee Ellen Bach, BSL
• Madeline Snow Bainbridge
• Thomas G. Baker, PHD
• Jason Elmer Balthaser, D.C.
• Sarah Balthaser, DC
• Stephen Patrick Banco, MD
• Argentina Bancos, LCSW
• Carla Banducci
• Nina Sara Bandyopadhyay, D.O.

• General Practice Dentistry in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.