Steven Leo Balt, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A87849 Issued in CA

Practice address

705 4TH St
Suite 4
San Rafael, CA 94901-3233

Phone

(415) 484-2258

Fax

(415) 684-7774

NPI assigned

Feb 25, 2008

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 11, 2015 through Nov 11, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Fremont, CA
  • NPI 1164555660
  NPD (past)
• Schuman-Liles Clinic, Inc

  • Psychiatry Physician
  • Oakland, CA
  • NPI 1861568909
  NPD (past)

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1235308297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 4TH ST",
            "address_2": "SUITE 4",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013233",
            "telephone_number": "415-484-2258",
            "fax_number": "415-684-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 4TH ST",
            "address_2": "SUITE 4",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013233",
            "telephone_number": "415-484-2258",
            "fax_number": "415-684-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALT",
        "first_name": "STEVEN",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A87849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Marie Baker, MS
• Martina Bakebura Bakilana
• Danielle Balestra, PA
• Kelsey Ball, PSYD
• Tatiana Ballinger
• David Sequino Bambilla, DPT
• Brian J. Bane, MD
• Mary Banh
• Edward W. Banks, MD
• Jessie Dennis Bannister, M.S.

• Psychiatry Physician in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.