Individual provider Active NPI

Jeffrey Daniel Balduzzi, M.D.

  • Allergy Physician
  • Stockton, CA
National Provider Identifier
1235405952
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
A173115 Issued in CA
Practice address
4628 Georgetown PL
Stockton, CA 95207-6204
Phone
(209) 951-5353
Fax
(209) 951-5369
NPI assigned
Mar 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X A173115 CA Primary

Addresses

Primary practice location

4628 Georgetown PL
Stockton, CA 95207-6204

Mailing address

4628 Georgetown PL
Stockton, CA 95207-6204
Phone (209) 951-5353

Other practice location 1

5609 J St Ste C
Sacramento, CA 95819-3957
Phone (916) 453-8696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20221121001737 CA Practitioner - Allergy/Immunology 9537496823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Virginia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy Immunology and Asthma Medical Group IncGroup PAC ID 7618041922, 4 clinicians

Practice addresses (Care Compare)

4628 Georgetown PL
Stockton, CA 95207-6204
Phone (209) 951-5353

Merit-based Incentive Payment System (MIPS)

Final score
95.97 of 100Reported as group
Quality
100
Improvement activities
40
Cost
79.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A173115CAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Physicians Care Solutions, Inc. Past Accepting new patients
Capital Allergy and Respiratory Disease Center a Med Corp Allergy Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1235405952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4628 GEORGETOWN PL",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076204",
            "telephone_number": "209-951-5353",
            "fax_number": "209-951-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4628 GEORGETOWN PL",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076204",
            "telephone_number": "209-951-5353",
            "fax_number": "209-951-5369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5609 J St Ste C",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958193957",
            "country_code": "US",
            "telephone_number": "916-453-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDUZZI",
        "first_name": "JEFFREY",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "A173115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.