Individual provider Active NPI

Shivaiah Balachandra, MD

  • Pediatric Nephrology Physician
  • Galveston, TX
National Provider Identifier
1053361287
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
N1542 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-5302
Phone
(409) 772-2222
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X N1542 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-5302

Mailing address

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20080328000055 TX Practitioner - Pediatric MedicinePractitioner - Nephrology 8628028263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Feb 1, 2008 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

301 University Blvd
Fl 6
Galveston, TX 77555

511 Park Grove Dr
Katy, TX 77450
Phone (281) 398-7001

200 Blossom St
Webster, TX 77598
Phone (281) 252-7000

Interoperability endpoints

  • Direct secure messaging: sbalachandrambbs15150@direct.utmb.edu

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1053361287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALACHANDRA",
        "first_name": "SHIVAIAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "N1542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.