Individual provider Active NPI

Marshall Samuel Balish, MD-PHD

  • Neurology Physician
  • Washington, DC
National Provider Identifier
1427140391
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
19276 Issued in DC
Practice address
Washington VA Medical Ctr
50 Irving St.
Washington, DC 20422-0001
Phone
(202) 745-8144
Fax
(202) 745-8231
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 19276 DC Primary
Clinical Neurophysiology Physician 2084N0600X 19276 DC

Addresses

Primary practice location

Washington VA Medical Ctr
50 Irving St.
Washington, DC 20422-0001

Mailing address

11902 Renwood LN
Rockville, MD 20852-4343
Phone (202) 745-8144

Other identifiers 2

IdentifierTypeStateIssuer
0452770MedicaidDC
77472MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20140425001153 DC Order and Referring Only - NeurologyPractitioner - Neurology 8820221963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19276DCMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1427140391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11902 RENWOOD LN",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524343",
            "telephone_number": "202-745-8144",
            "fax_number": "202-745-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WASHINGTON VA MEDICAL CTR",
            "address_2": "50 IRVING ST.",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "204220001",
            "telephone_number": "202-745-8144",
            "fax_number": "202-745-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALISH",
        "first_name": "MARSHALL",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD-PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "DC",
            "license": "19276",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "DC",
            "license": "19276",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452770",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77472",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.