Active NPI
Ronaldo A Ballecer, MD
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Fresno, CA
National Provider Identifier
1194941641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- License
- A34864
- Practice address
- 540 E Herndon Ave Ste 105
Suite 105
Fresno, CA 93720-2993 - Phone
- (559) 432-5154
- Fax
- (559) 432-8763
- NPI assigned
- Apr 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | A34864 | CA | Primary |
Addresses
Primary practice location
540 E Herndon Ave Ste 105
Suite 105
Fresno, CA 93720-2993
Mailing address
540 East Herndon Ave
Ste 105
Frenso, CA 93720-2993
Phone (559) 432-5154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0100870 | Medicaid | CA |
Other names 1
- Mr. Ronaldo A Ballecer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A34864 | CA | MD | Plastic Surgery within the Head & Neck (Otolaryngology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1194941641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 EAST HERNDON AVE",
"address_2": "STE 105",
"city": "FRENSO",
"state": "CA",
"postal_code": "937202993",
"telephone_number": "559-432-5154",
"fax_number": "559-432-8763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 E HERNDON AVE STE 105",
"address_2": "SUITE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202993",
"telephone_number": "559-432-5154",
"fax_number": "559-432-8763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLECER",
"first_name": "RONALDO",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "CA",
"license": "A34864",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0100870",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RONALDO",
"last_name": "BALLECER",
"middle_name": "A",
"prefix": "MR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.