Individual provider Active NPI

Zachary E Ballenger, MD

  • Diagnostic Radiology Physician
  • Orange City, FL
National Provider Identifier
1417236902
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME144863 Issued in FL
Practice address
1055 Saxon Blvd
Orange City, FL 32763-8468
Phone
(386) 917-5000
NPI assigned
Aug 15, 2011
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11016227A IN
Diagnostic Radiology Physician 2085R0202X 01071787A IN
Diagnostic Radiology Physician 2085R0202X Q4896 TX
Diagnostic Radiology Physician 2085R0202X ME144863 FL Primary

Addresses

Primary practice location

1055 Saxon Blvd
Orange City, FL 32763-8468

Mailing address

1055 Saxon Blvd
Orange City, FL 32763-8468
Phone (386) 917-5000

Other identifiers 1

IdentifierTypeStateIssuer
201106150MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200714000426 FL Practitioner - Diagnostic Radiology 5799921227 Reassigns benefits to 3 organizations
I20220330003122 KY Practitioner - Diagnostic Radiology 5799921227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

1480 W Orange Blossom TRL
Adventhealth Imaging Apopka
Apopka, FL 32712-2637
Phone (407) 200-5440

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

1919 E Hwy 50 101
Adventhealth Imaging Center Clermon
Clermont, FL 34711-1975
Phone (352) 717-3738

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

2200 Fowler Grove Blvd
Suite 60
Winter Garden, FL 34787-5597
Phone (407) 200-0538

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

2488 E Irlo Bronson Memorial Hwy
Ahi Partin Settlement
Kissimmee, FL 34744-4948
Phone (407) 200-5440

25 S Terry Ave
Suite 220
Orlando, FL 32805-1843
Phone (407) 641-2446

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

661 E Altamonte Dr
Suite 130
Altamonte Springs, FL 32701-5102
Phone (407) 303-2155

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11016227AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jun 6, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 6, 2024 Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Aug 17, 2020 Accepting new patients

Locations

900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

900 Winderley Pl
Ste 1100
Maitland, FL 32751
Phone (407) 200-1606

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: zballenger58827@adventhealth.direct-ci.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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1417236902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 SAXON BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638468",
            "telephone_number": "386-917-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SAXON BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638468",
            "telephone_number": "386-917-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENGER",
        "first_name": "ZACHARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "11016227A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01071787A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "Q4896",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME144863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201106150",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.