Paul Ballas

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

OS013706 Issued in PA

Practice address

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343

Phone

(215) 831-7935

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Eastern Pennsylvania Physician Alliance LLC

  • Neurology Physician
  • Clarion, PA
  • NPI 1902440621
  Medicare reassignment NPD

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1033256235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-831-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191242343",
            "telephone_number": "215-831-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLAS",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "OS013706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shefali Sudhir Ballal, M.D.
• Allison Ballantine, M.D.
• Cadesha Coreen Ballard
• Melody Ballard
• Christos Ballas, MD
• William F Ballay, MD
• Digen Ballayan
• Chandler Ballbach
• Constance Lee Ballem Leach, CRNP
• Erica Baller

• Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.