Nicolette Lee Ballou, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G53313 Issued in CA

Practice address

8920 Wilshire Blvd
Ste 604
Beverly Hills, CA 90211

Phone

(310) 659-7867

Fax

(310) 659-0804

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

Howard University College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Prime Wellness Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1083251532
  Medicare reassignment NPD
• Cedars-Sinai Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1639172372
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457420077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD",
            "address_2": "STE 604",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90211",
            "telephone_number": "310-659-7867",
            "fax_number": "310-659-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8920 WILSHIRE BLVD",
            "address_2": "STE 604",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90211",
            "telephone_number": "310-659-7867",
            "fax_number": "310-659-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "NICOLETTE",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G53313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G53313",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Brian Balaze, D.M.D.
• Balestrieri Psychology Services, PA
• Stewart R Balikov, DDS
• Ellen Margaret Balkan, LCSW
• Jeffrey D Ball, PHD
• Mark Bamberger, M.D.
• Bahareh Rachel Banafsheh
• Ashley Negin Banayan, PA-C
• Rashel Bandari, PHARM.D
• Amit Banerjee, M.D.

• Pediatrics Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.