Ildiko Balla, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

32879 Issued in TX

Practice address

4200 S Hulen St Ste 658
Fort Worth, TX 76109-4987

Phone

(682) 597-3933

Fax

(817) 274-8443

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

91.17 of 100Reported as group

Quality

83.48

Improvement activities

40

Cost

67.52

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• Deer Oaks Geriatric Services P C

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  Medicare reassignment NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1437368446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 CLIFF PARK",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761341016",
            "telephone_number": "682-597-3933",
            "fax_number": "817-274-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S HULEN ST STE 658",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094987",
            "telephone_number": "682-597-3933",
            "fax_number": "817-274-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLA",
        "first_name": "ILDIKO",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "16553",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "32879",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "32879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028537102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingabire Grace Balinda, MD
• Amy Brown Balis, MD
• Allison Elaine Ball, PT, DPT
• Lauren Rebecca Ball, PA-C
• Linda J Ball, DO
• Bruce Ballard, CRNA
• David Ballard, DDS
• Vonda Ballard
• James Edward Ballenger, LCSW
• Issac Roy Ballesteros, 101Y00000X

• Clinical Psychologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.