Pamela Ballard, MD
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Washington, DC
NPI 1366410722 · NPPES record last updated Dec 10, 2007
Key facts
- NPI
- 1366410722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- 19091 (DC)
- Practice address
- 102 Irving St NW
Washington, DC 20010-2921 - Phone
- (202) 877-1170
- NPI assigned
- Mar 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- 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 |
|---|---|---|---|---|
| I20101112000635 | DC | Practitioner - Physical Medicine and Rehabilitation | 2961697107 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19091 | DC | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medstar Medical Group II LLC | Current |
Accepting new patients |
Locations
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
102 Irving St NW
Washington, DC 20010
Phone (202) 877-1587
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 19091 | DC | Yes |
Addresses
Primary practice location
102 Irving St NW
Washington, DC 20010-2921
Mailing address
102 Irving St NW
Washington, DC 20010-2921
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112522 | Other | KAISER | |
| 411438 | Other | MAMSI | |
| 7639069003 | Other | CIGNA | |
| 520846-01 | Other | MD | BS OF MD |
| 5460-0036 | Other | DC | BS OF NCA |
| 852241 | Other | AETNA HMO | |
| 4398916 | Other | AETNA | |
| 494959 | Other | NCPPO |
Other providers in Washington, DC
- April Kavanagh Ballard
- Elizabeth Day Ballard
- Frances Hall Ballard
- James Moses Ballard II
- Nitai Ballard
- Ricca Ballard
- Stacy Ballard
- Victoria Lachais Ballard
- Laura Ballariel
- Balldinger & Miller
All providers in Washington, DC · Physical Medicine & Rehabilitation Physician in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2007. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.