Individual provider Active NPI

Avinash Lutchmidath Ballie, M.D.

  • Anesthesiology Physician
  • Utica, NY
National Provider Identifier
1164722013
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
260616 Issued in NY
Practice address
1676 Sunset Ave
Utica, NY 13502
Phone
(315) 724-3456
Fax
(315) 724-6734
NPI assigned
Oct 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 260616 NY Primary

Addresses

Primary practice location

1676 Sunset Ave
Utica, NY 13502

Mailing address

136 Evergreen LN
Whitesboro, NY 13492-2553
Phone (646) 334-4436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110819000313 NY Practitioner - Anesthesiology 5193995645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
State University of New York Downstate Medical Center, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 624-6000

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260616NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Nov 1, 2020 Accepting new patients
MVHS Inc CurrentSince Nov 1, 2020 Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: aballie12998@mvhealthsystem.direct-ci.com

Organizations & group practices 2

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 1

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": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1164722013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 EVERGREEN LN",
            "city": "WHITESBORO",
            "state": "NY",
            "postal_code": "134922553",
            "telephone_number": "646-334-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "13502",
            "telephone_number": "315-724-3456",
            "fax_number": "315-724-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLIE",
        "first_name": "AVINASH",
        "middle_name": "LUTCHMIDATH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "260616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.