Individual provider Active NPI

Ronaldo A Ballecer, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Fresno, CA
National Provider Identifier
1194941641
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
A34864 Issued in CA
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

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
GR0100870MedicaidCA

Other names 1

  • Mr. Ronaldo A Ballecer Other name

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

LicenseStateTypeSpecialty
A34864CAMDPlastic 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.

Verify at the official NPI Registry.