NPIMap

Alexis Robin Balomenos, M.D.

Individual provider Active NPI Pediatrics Physician · New Haven, MI

NPI 1477569903 · NPPES record last updated Aug 29, 2011

Key facts

NPI
1477569903
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
4301066394 (MI)
Practice address
58115 Main St
New Haven, MI 48048-2686
Phone
(586) 749-4444
Fax
(586) 749-9114
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301066394MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Care Pediatrics, PLLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: abalomenos@tcp.directglo.com
  • Direct secure messaging: abalomenos1116161@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301066394 MI Yes

Addresses

Primary practice location

58115 Main St
New Haven, MI 48048-2686

Mailing address

58115 Main St
New Haven, MI 48048-2686
Phone (586) 749-4444

Other identifiers

IdentifierTypeStateIssuer
4129423MedicaidMI

Other providers in New Haven, MI

All providers in New Haven, MI · Pediatrics Physician in Michigan

Sources for this page

Verify at the official NPI Registry.