Kevin Daniel Balderrama, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

Baystate Medical Center 759 Chestnut Street Springfield
Springfield, MA 01199-0001

Phone

(413) 794-0000

NPI assigned

Jun 27, 2022

Sex

Male

Sole proprietor

No

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 MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1205568482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BAYSTATE MEDICAL CENTER 759 CHESTNUT STREET SPRINGFIELD",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011990001",
            "telephone_number": "413-794-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYSTATE MEDICAL CENTER 759 CHESTNUT STREET SPRINGFIELD",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011990001",
            "telephone_number": "413-794-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDERRAMA",
        "first_name": "KEVIN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrin Bakhl, MD
• Emelia Bakowski
• Edward Lee Balaban, MD
• Marley Balasco
• Andrew H Balder, MD
• Stacie E Baldwin, PA-C
• Lourdes T. Balestier
• Ludemar Ball-Mora
• Kathryn Ball, PT
• Aribet Ballester Santiago

• All providers in Springfield, MA
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.