Gerald J Balsam, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME23057 Issued in FL

Practice address

736 N Magnolia Ave
Advanced Psychiatric Group, P.a.
Orlando, FL 32803-3809

Phone

(407) 423-7149

Fax

(407) 422-0470

NPI assigned

Nov 21, 2006

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2016 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1487729059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 N MAGNOLIA AVE",
            "address_2": "ADVANCED PSYCHIATRIC GROUP, P.A.",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033809",
            "telephone_number": "407-423-7149",
            "fax_number": "407-422-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 N MAGNOLIA AVE",
            "address_2": "ADVANCED PSYCHIATRIC GROUP, P.A.",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033809",
            "telephone_number": "407-423-7149",
            "fax_number": "407-422-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALSAM",
        "first_name": "GERALD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME23057",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0023057",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038468200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristan Ballmann, APRN
• Jason Willard Balls, PA
• Teige Jeanette Ballweber, APRN
• Whitney Hanna Balmert, PA
• Kim A Balogh, PA
• Samantha Rose Balsamo
• Lindsey Balta, MD
• Carrie Nicole Balthazar, ARNP
• Saba Balvardi
• Carmelita Bamba Dagani, MD

• Psychiatry Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.