Michael Ballard, PA-C
Individual provider Active NPI Physician Assistant · Albany, NY
NPI 1407665136 · NPPES record last updated Mar 5, 2025
Key facts
- NPI
- 1407665136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 319 S Manning Blvd Ste 106
Albany, NY 12208-1743 - Phone
- (518) 438-1019
- NPI assigned
- Jan 7, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Peter'S Health Partners Medical Associates, P.C.
Practice addresses (Care Compare)
2 New Hampshire Ave
Troy, NY 12180-1764
Phone (518) 525-8220
319 S Manning Blvd
Albany, NY 12208-1743
Hospital & facility affiliations
- St Peter'S Hospital
- Samaritan Hospital of Troy, New York
- Columbia Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250306001780 | NY | Practitioner - Physician Assistant | 1153842141 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032969 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Peter'S Health Partners Medical Associates, P.C. | Physician Assistant | Current |
Accepting new patients |
| St. Peter'S Health Partners Medical Associates, P.C. | Physician Assistant | Past | Accepting new patients |
Locations
4 Executive Park Dr
Ste 2
Albany, NY 12203
Phone (518) 435-1231
319 S Manning Blvd
Ste 106
Albany, NY 12208
Phone (518) 438-0507
2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331
2231 Burdett Ave
Ste 160
Troy, NY 12180
Phone (518) 272-1333
Interoperability endpoints
- mballard4060200@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
319 S Manning Blvd Ste 106
Albany, NY 12208-1743
Mailing address
PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634
Other providers in Albany, NY
- Elizabeth Verginia Ball
- Kelsey Ball
- Wendy Ball
- Alyssa Maria Ballantyne
- Kristene Ballard
- Galen Whitney Ballentine
- Jacob Anthony Ballmes
- Aneesha Khan Baloch
- Jamila Balooch
- Bambor
All providers in Albany, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2025. 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.