Patrick L Ballou, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4900 Issued in AZ

Practice address

5330 S Highway 95
Fort Mohave, AZ 86426-9225

Phone

(928) 788-7065

NPI assigned

Sep 8, 2011

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 AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Paramount Behavioral Health Services PLLC

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1366941361

  AZ

  Medicare reassignment Care Compare group
• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433

  AZ

  Medicare reassignment
• Emergency Physicians Professional Association LTD

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1114931490
  NPD (past)
• Valley Emergency Physicians Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1043224322
  NPD (past)

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paramount Behavioral Health Services PLLC 11 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1124309844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 W BURNSIDE TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850858071",
            "telephone_number": "307-977-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 S HIGHWAY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269225",
            "telephone_number": "928-788-7065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "PATRICK",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arizona CVS Stores, L.L.C.
• Arizona Physician Services LLC
• Assisted Living Locators - Transportation
• Assisted Living Locators-Transportation
• Ian Lloyd Ruiz Baccay, RN
• Rose Marie Bard-Jensen, NP
• Kayla Barnett, PA-C
• Alan Joseph Barton, MD
• Hylie Elaine Barton, BCBA
• Mervat Basta, M.D.

• All providers in Fort Mohave, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.