Vijay Balakrishnan, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

LL52671 Issued in SC

Practice address

655 Euclid Ave Ste 304
National City, CA 91950-2974

Phone

(619) 267-8303

NPI assigned

Jun 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, ID2 enrollments

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 2

Specialty

Dermatology

Education

Emory University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ada West Dermatology, P.C.Group PAC ID 1153341532, 26 clinicians

William F Resh MD Skin and Skin Cancer Medical Group of San Diego IncGroup PAC ID 4082601935, 18 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vijay.balakrishnan@epiphanyderm.emadirect.md

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.

• Ada West Dermatology, PC

  • Dermatology Physician
  • Meridian, ID
  • NPI 1518973338

  Dermatology, ID

  Medicare reassignment Care Compare group NPD
• William F Resh MD, Skin & Skin Cancer Medical Group of San Diego, Inc.

  • Specialist
  • National City, CA
  • NPI 1790973162

  CA, Dermatology

  Medicare reassignment Care Compare group NPD (past)
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  NPD
• William F Resh M.D. Skin & Skin Cancer Medical Group of San Diego, Inc

  • Dermatology Physician
  • San Diego, CA
  • NPI 1831938232

  Dermatology

  NPD
• William F Resh M.D. Skin & Skin Cancer Medical Group of San Diego, Inc

  • Dermatology Physician
  • El Cajon, CA
  • NPI 1912186917

  Dermatology

  NPD

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1104311596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 20TH ST S STE 858",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE STE 304",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502974",
            "telephone_number": "619-267-8303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1618 S Millenium Way Ste 100",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426457",
            "country_code": "US",
            "telephone_number": "208-884-3376",
            "fax_number": "208-884-0858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALAKRISHNAN",
        "first_name": "VIJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "LL52671",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "ID",
            "license": "9971137",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "9971137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia M. Bailey, MS, FNP-BC
• Ahmad L Bailony, M.D.
• Mohammed T Bailony, MD
• Vicky Gillian Baird
• Gary Anthony Baker II
• Natalie Ballard
• Douglas A Ballesteros, MD
• Irene Balnis
• Teresita Trimor Barbadillo, M.D.
• Barefeet Podiatry Inc

• All providers in National City, CA
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.
• 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.