Individual provider Active NPI

Gulnar Balsara, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Mount Holly, NJ
National Provider Identifier
1164422291
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA06877300 Issued in NJ
Practice address
175 Madison Ave
Mount Holly, NJ 08060-2038
Phone
(609) 922-0116
NPI assigned
Jul 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA06877300 NJ Primary

Addresses

Primary practice location

175 Madison Ave
Mount Holly, NJ 08060-2038

Mailing address

175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (609) 261-7095

Other identifiers 2

IdentifierTypeStateIssuer
0062630000OtherNJBLUE CROSS BLUE SHIELD
8048100MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040421001096 NJ Practitioner - Pathology 0042206575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Pathology Consultants, PAGroup PAC ID 9638144983, 10 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3000

Hospital & facility affiliations

  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
76.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06877300NJMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Consultants of South Jersey PC CurrentSince May 1, 2018 Accepting new patients
Diagnostic Pathology Consultants PA Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2004 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients

Locations

520 E 22nd St
Lombard, IL 60148
Phone (630) 874-2542

1919 S Highland Ave
Ste 210A
Lombard, IL 60148

1000 Atlantic Ave
Camden, NJ 08104
Phone (856) 246-3060

693 Main St
Ste A
Lumberton, NJ 08048
Phone (609) 261-8200

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

101 Carnie Blvd
Voorhees, NJ 08043
Phone (856) 325-3000

Organizations & group practices 3

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 4

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1164422291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602038",
            "telephone_number": "609-261-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MADISON AVE",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602038",
            "telephone_number": "609-922-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALSARA",
        "first_name": "GULNAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-29",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA06877300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0062630000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8048100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

Verify at the official NPI Registry.