Manci M Balas Hoesley, MD
Individual provider Active NPI Pediatrics Physician · Vestavia, AL
NPI 1477522175 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1477522175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 00017481 (AL)
- Practice address
- 3735 Corporate Woods Dr Ste 105
Vestavia, AL 35242-2296 - Phone
- (205) 900-7337
- Fax
- (855) 583-3156
- NPI assigned
- Mar 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200411000030 | AL | Practitioner - Pediatric Medicine | 2961831011 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00017481 | AL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ross Bridge Medical Practice LLC | Pediatrics | Current |
Accepting new patients |
| Your Kids Urgent Care Alabama | Pediatrics | Current |
Accepting new patients |
| Purohit Pediatric Clinic, LLC | Past |
Accepting new patients |
Locations
3635 Market St
Ste A
Hoover, AL 35226
Phone (205) 494-7677
3635 Market St
Hoover, AL 35226
Phone (205) 494-7677
790 Montgomery Hwy
Ste 112
Vestavia Hills, AL 35216
Phone (205) 769-6800
4040 49th St N
St Petersburg, FL 33709
Phone (727) 526-6483
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/ACBGBD/Endpoint/ACBGBD
- mbalas@ppc.gwaydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 00017481 | AL | Yes |
Addresses
Primary practice location
3735 Corporate Woods Dr Ste 105
Vestavia, AL 35242-2296
Mailing address
3735 Corporate Woods Dr Ste 105
Vestavia, AL 35242-2296
Phone (205) 900-7337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051022734 | Other | AL | BLUE SHIELD |
| 303730278 | Medicaid | AL | |
| 051519831 | Other | AL | BLUE SHIELD |
| 303720278 | Medicaid | AL | |
| 303740278 | Medicaid | AL | |
| 051034755 | Other | AL | BLUE SHIELD |
| 051539291 | Other | AL | BLUE SHIELD |
| 051034754 | Other | AL | BLUE SHIELD |
| 303790278 | Medicaid | AL |
Other names
- Manci M Balas
Other providers in Vestavia, AL
- Frankqunetta Bailey
- Telishay Rocquel Bailey
- Kaitlyn Mayanna Bainbridge
- Kevaun Baird
- Joshua David Baker
- Regan Baldwin
- Aaron Todd Ballou
- Aimee Nicole Bals
- Bart B Bamberg
- Ariana Banks
All providers in Vestavia, AL · Pediatrics Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.