Active NPI
Pablo E Balboa-Marciack, MD
- Family Medicine Physician
- Calhoun, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 055409
- Practice address
- 100 Hospital CT
Calhoun, GA 30701-2077 - Phone
- (706) 602-8200
- Fax
- (706) 602-1354
- NPI assigned
- Jul 14, 2006
- Last updated
- Dec 13, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 055409 | GA | Primary |
Addresses
Primary practice location
100 Hospital CT
Calhoun, GA 30701-2077
Mailing address
PO Box 12938
C/O Clinic Management
Calhoun, GA 30703
Phone (706) 602-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135418395C | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Hospital CT
Calhoun, GA 30701-2077
Phone (706) 602-8200
1035 Red Bud Rd NE
Calhoun, GA 30701-6010
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.79 of 100
- Quality
- 68.23
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.67
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055409 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health System Georgia Inc | Current | Accepting new patients |
Locations
100 Hospital Ct
Calhoun, GA 30701
Phone (706) 602-8200
1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800
Interoperability endpoints
- pbalboamarciack661733@adventhealth.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba AdventHealth Medical Group
- Multi-Specialty Clinic/Center
- Calhoun, GA
- NPI 1699791343
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adventhealth Home Health
- Home Health Agency
- Calhoun, GA
- NPI 1073555256
-
dba AdventHealth Gordon
- General Acute Care Hospital
- Calhoun, GA
- NPI 1760402424
-
dba North Georgia Home Health Agency, an Amedisys Company
- Home Health Agency
- Ringgold, GA
- NPI 1548218290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544659200000",
"number": "1255357067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12938",
"address_2": "C/O CLINIC MANAGEMENT",
"city": "CALHOUN",
"state": "GA",
"postal_code": "30703",
"telephone_number": "706-602-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL CT",
"city": "CALHOUN",
"state": "GA",
"postal_code": "307012077",
"telephone_number": "706-602-8200",
"fax_number": "706-602-1354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALBOA-MARCIACK",
"first_name": "PABLO",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-14",
"last_updated": "2018-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "055409",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "135418395C",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Calhoun, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.