Imelda Marie Balboni, MD, PHD

Primary specialty

Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X

License

A74553 Issued in CA

Practice address

725 Welch Rd
Palo Alto, CA 94304-1601

Phone

(650) 497-8000

NPI assigned

Jan 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• LPCH Medical Group Div of Lucile

  dba Lucile Salter Packard Children's Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940

  Pediatrics

  Medicare reassignment NPD
• Stanford Health Care

  dba Stanford Medical Center A Trade Name for Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927

  Pediatrics

  Medicare reassignment NPD
• Stanford Health Care

  dba Stanford Health Care Emeryville 5800

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1275076325

  Pediatrics

  NPD
• Stanford Health Care

  dba Stanford Health Care Specialty Pharmacy

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303
  NPD (past)
• Lucile Salter Packard Children's Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1467442749
  NPD (past)
• Stanford Hospital and Clinics

  dba SHC Reference Laboratory

  • Clinical Medical Laboratory
  • Palo Alto, CA
  • NPI 1174698468
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1407903842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "address_2": "BOSWELL BUILDING A085",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-8295",
            "fax_number": "650-736-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pasteur Dr",
            "address_2": "Boswell Building A085",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943052200",
            "country_code": "US",
            "telephone_number": "650-723-8295",
            "fax_number": "650-736-4344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALBONI",
        "first_name": "IMELDA",
        "middle_name": "MARIE",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A74553",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "CA",
            "license": "A74553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arvind Balaji, MD
• Karthik Balakrishnan, MD, MPH
• Aurelia Balan, MD
• Erika Balassiano, MD
• Malathi Balasundaram, MD
• Patricia Hobbs Baldwin, N.P.
• Richard Norman Bale, PH.D.
• Alexander John Ball, MD
• Tali Manber Ball, PHD
• Melissa Ann Ballard, NP

• Pediatric Rheumatology Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Pediatric Rheumatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.