Individual provider Active NPI

Brandon J Ballister, RPA-C

  • Medical Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1225313430
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015250 Issued in NY
Practice address
45 Reade PL
Poughkeepsie, NY 12601-3947
Phone
(845) 454-8500
NPI assigned
Oct 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015250 NY Primary
Physician Assistant 363A00000X 015250 NY

Addresses

Primary practice location

45 Reade PL
Poughkeepsie, NY 12601-3947

Mailing address

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20111121000482 NY Practitioner - Physician Assistant 2769656123 Reassigns benefits to 4 organizations
I20250730002429 CT Practitioner - Physician Assistant 2769656123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

1011 High Ridge Rd
Suite 101
Stamford, CT 06905-1604
Phone (475) 477-2330

1240 Ulster Ave
Kingston, NY 12401-1517
Phone (845) 585-1270

1530 Route 9
Wappingers Falls, NY 12590-4131
Phone (845) 218-1892

1643 Route 82
Suite 4
Lagrangeville, NY 12540-6040
Phone (845) 592-9138

186 Route 52
Carmel, NY 10512-1200
Phone (845) 936-0002

205 Main St
Suite 7
Norwalk, CT 06851-3530
Phone (475) 257-6057

3 Sugar Hollow Rd
Danbury, CT 06810-7401
Phone (475) 348-3782

377 S Oyster Bay Rd
Plainview, NY 11803-3323
Phone (516) 537-9061

703 Route 9
Suite 3
Fishkill, NY 12524-3672
Phone (845) 202-5044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015250NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Sep 2, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Sep 2, 2020 Accepting new patients
Nuvance Health Medical Practice PC Medical Past Accepting new patients
Hudson Valley Emergency Medicine PLLC Past Accepting new patients
Eos Medical Group PC Past Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

670 Stoneleigh Ave
Carmel, NY 10512
Phone (845) 230-4721

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

42158 State Highway 28
Margaretville, NY 12455
Phone (845) 586-1800

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/
  • Direct secure messaging: brandon.ballister@ghuc.eclinicaldirectplus.com

Organizations & group practices 9

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1225313430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-454-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-454-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLISTER",
        "first_name": "BRANDON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015250",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015250",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.