Mamtha Balla, MD.,MPH

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1018990 Issued in MA

Practice address

75 Francis St
Boston, MA 02115-6110

Phone

(617) 732-5500

NPI assigned

Jun 19, 2012

Sex

Female

Sole proprietor

No

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

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mballa13291@direct.promedica.org

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment NPD

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1346503034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2142 N Cove Blvd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436063895",
            "country_code": "US",
            "telephone_number": "419-291-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLA",
        "first_name": "MAMTHA",
        "credential": "MD.,MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1018990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ball, PA-C
• Jordan Ball, MS, RD, LDN
• Matthew Ball, MD
• Sade Monay Ball, NONE
• Amalia Balla, DDS
• Sonia Arora Ballal, M.D.
• Katie Ballantyne, MD
• Carmine Ballarano, MD
• Chelsey Ballard
• Catherine Louisiana Ballif, MA, CCC-SLP

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.