Andrew Peter Balbaugh, M.D.
Individual provider Active NPI Internal Medicine Physician · Georgetown, KY
NPI 1265640411 · NPPES record last updated Feb 11, 2017
Key facts
- NPI
- 1265640411
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 41057 (KY)
- Practice address
- 196 Bevins LN
Suite F
Georgetown, KY 40324-8534 - Phone
- (502) 863-2818
- Fax
- (502) 863-2764
- NPI assigned
- May 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Northeastern Ohio University College of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kentucky Mso LLC
Practice addresses (Care Compare)
1138 Lexington Rd
Suite 130
Georgetown, KY 40324-9673
Phone (502) 570-2324
175 Hospital Dr
Suite 120
Georgetown, KY 40324
Phone (502) 570-2324
Hospital & facility affiliations
- Georgetown Community Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071005000097 | KY | Practitioner - Internal Medicine |
4880789841 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41057 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kentucky Mso LLC | Current |
Accepting new patients | |
| Kentucky Mso LLC | Current |
Accepting new patients | |
| Kentucky Mso LLC | Internal Medicine | Current | Accepting new patients |
| Kentucky Mso LLC | Past | Accepting new patients | |
| Georgetown Community Hospital LLC | Past | Accepting new patients |
Locations
196 Bevins Ln
Ste F
Georgetown, KY 40324
Phone (502) 863-2818
1140 Lexington Rd
Georgetown, KY 40324
Phone (502) 868-1100
1140 Lexington Rd
Ste 105
Georgetown, KY 40324
Phone (502) 868-5660
330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780
Interoperability endpoints
- andrew.balbaugh.1@19475.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 41057 | KY | |
| Internal Medicine Physician | 207R00000X | 41057 | KY | Yes |
Addresses
Primary practice location
196 Bevins LN
Suite F
Georgetown, KY 40324-8534
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7906
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100011650 | Medicaid | KY |
Other providers in Georgetown, KY
- Daniel Ryan Baker
- John Max Baker
- Kimberly Dione Baker
- Rebecca Lynn Baker
- Julia Jane Balash
- Jordan Taylor Balkin
- Baptist Health Medical Group Inc
- Baptist Health Medical Group Inc
- Baptist Health Medical Group Inc
- Baptist Healthcare System Inc
All providers in Georgetown, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.