Douglas A. Ballan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA57331 Issued in NJ

Practice address

45 Elm Ave
This Is Doctor'S Home; There Is No Office.
Fanwood, NJ 07023-1203

Phone

(908) 279-3477

Fax

(908) 345-6111

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Community Hospital Group, Inc

  • Specialist
  • Edison, NJ
  • NPI 1427278258
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1508893199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070760122",
            "telephone_number": "908-279-3477",
            "fax_number": "908-345-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 ELM AVE",
            "address_2": "THIS IS DOCTOR'S HOME; THERE IS NO OFFICE.",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231203",
            "telephone_number": "908-279-3477",
            "fax_number": "908-345-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLAN",
        "first_name": "DOUGLAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA57331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "733566",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent Paul Alvino, DMD
• Robert Anthony Apuzzio, DC
• Babbitt Chiropractic Center
• Grant L Babbitt, D.C.
• Delaney Baliko
• Lawrence Bauman, DDS
• Rebecca Beauvais, RN
• Julie K Bennett
• Ileana Bernal-Schnatter, MD
• Laura Bianciella, OTR/L

• Family Medicine Physician in Fanwood, NJ
• Providers in Fanwood, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.