Shelby Ballaron, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1900 E Commercial Blvd Ste 201
Fort Lauderdale, FL 33308-3746

Phone

(954) 928-1778

NPI assigned

May 21, 2018

Last updated

Dec 8, 2021By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sballaron2021151@direct.trinity-health.org

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.

• Holy Cross Hospital Inc

  dba Holy Cross Medical Group

  • Internal Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1467401877
  Medicare reassignment NPD
• Holy Cross Hospital, Inc

  dba Holy Cross Diabetes Prevention Program

  • Health & Wellness Coach
  • Oakland Park, FL
  • NPI 1063207595
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1457842924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E COMMERCIAL BLVD STE 201",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083746",
            "telephone_number": "954-928-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E COMMERCIAL BLVD STE 201",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083746",
            "telephone_number": "954-928-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Elden St Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Herndon",
            "state": "VA",
            "postal_code": "201704875",
            "country_code": "US",
            "telephone_number": "703-709-9771",
            "fax_number": "888-519-0045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALLARON",
        "first_name": "SHELBY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110-006205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841550035",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ryxh6995@providers.hcfl.myhealthprovider.org",
            "affiliation": "N",
            "endpointDescription": "Holy Cross Fort Lauderdale Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1900 E Commercial Blvd Ste 201",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333083746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jose Baldriche
• Jillian Claire Baldwin, PSY.D.
• Ashley Danielle Baldyga
• Naomi Hope Balingcongan
• Cherie Ballard
• Natalee B Balseiro, LMHC
• Mia Isabel Banag
• Tanisha Bandoo, MS,RDN,CDN,LDN
• Ana Andreea Banica, PA-C
• Sophia Bankole, IMH

• Physician Assistant in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.