Individual provider Active NPI

Harold A Ballitch II, MD

  • Ophthalmology Physician
  • Ontario, OH
National Provider Identifier
1275523896
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
35063411 Issued in OH
Practice address
1991 Park Ave W
Ontario, OH 44906-2233
Phone
(419) 521-3937
Fax
(419) 522-5189
NPI assigned
Oct 25, 2005
Last updated
Feb 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 35063411 OH Primary

Addresses

Primary practice location

1991 Park Ave W
Ontario, OH 44906-2233

Mailing address

1991 Park Ave W
Ontario, OH 44906-2233
Phone (419) 564-2855

Other identifiers 1

IdentifierTypeStateIssuer
0878420MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040123000058 OH Practitioner - Ophthalmology 1052213048

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
18.04 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
60.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35063411OHMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Optical Company, LLC CurrentSince Dec 20, 2010 Accepting new patients
Advanced Eye Care Surgery Center LLC Current Accepting new patients
Ohiohealth Regional Physician Services, LLC Single Specialty PastSince Jul 1, 2019 Accepting new patients

Locations

1991 Park Ave W
Ontario, OH 44906
Phone (419) 521-3937

Interoperability endpoints

  • Direct secure messaging: hballitch@advancedeyecare.imwdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1275523896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062233",
            "telephone_number": "419-564-2855",
            "fax_number": "419-522-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 PARK AVE W",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449062233",
            "telephone_number": "419-521-3937",
            "fax_number": "419-522-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLITCH",
        "first_name": "HAROLD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35063411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0878420",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OH

Sources for this page

Verify at the official NPI Registry.