Individual provider Active NPI

Glenn Mark Balfour, M.D.

  • Neurology Physician
  • Carlsbad, CA
National Provider Identifier
1104931542
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A86632 Issued in CA
Practice address
785 Grand Ave Ste 218
Carlsbad, CA 92008-2371
Phone
(442) 500-8851
Fax
(442) 500-8681
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Spinal Cord Injury Medicine Physician 2081P0004X A86632 CA
Neurology Physician 2084N0400X A86632 CA Primary

Addresses

Primary practice location

785 Grand Ave Ste 218
Carlsbad, CA 92008-2371

Mailing address

5520 Los Robles Dr
Carlsbad, CA 92008-4424
Phone (760) 845-8884

Other identifiers 1

IdentifierTypeStateIssuer
BF428ZOtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20090121000637 CA Practitioner - NeurologyPractitioner - Psychiatry 0840354783 Practice locations: Sacramento, CA; Carlsbad, CA
O20151218000774 CA DME Supplier - Physician - General Surgery 4082937446 Practice locations: Sacramento, CA
O20180828001748 CA DME Supplier - Physician - Neurology 4082937446 Practice locations: Carlsbad, CA
O20250731001350 CA DME Supplier - Physician - Neurology 4082937446 Practice locations: National City, CA

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5350 Madison Ave
Sacramento, CA 95841-3169
Phone (916) 677-0008

550 E 8TH St
Suite 1
National City, CA 91950-2355

5520 Los Robles Dr
Carlsbad, CA 92008-2371

785 Grand Ave
Suite 218
Carlsbad, CA 92008-2371
Phone (619) 773-6255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Physical Therapy and Rehabilitation Services Inc. CurrentSince Sep 25, 2020 Accepting new patients
West Coast Medical Care Professional Corporation PastSince Apr 8, 2015 Accepting new patients
Good Health Medical Inc PastSince Nov 18, 2025 Accepting new patients
Michael Samko, PH.D., Inc. Past Accepting new patients

Locations

3142 E Plaza Blvd
Ste T
National City, CA 91950
Phone (619) 246-1136

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1104931542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 LOS ROBLES DR",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920084424",
            "telephone_number": "760-845-8884",
            "fax_number": "442-500-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 GRAND AVE STE 218",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082371",
            "telephone_number": "442-500-8851",
            "fax_number": "442-500-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALFOUR",
        "first_name": "GLENN",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "CA",
            "license": "A86632",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A86632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BF428Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

Verify at the official NPI Registry.