Active NPI
Martha Ballesteros, MD
- Pediatric Radiology Physician
- Miami, FL
National Provider Identifier
1508897216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- ME71982
- Practice address
- 3100 SW 62ND Ave
Radiology Department
Miami, FL 33155 - Phone
- (305) 662-8392
- Fax
- (305) 667-8689
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | 60960 | TN | |
| Pediatric Radiology Physician | 2085P0229X | 60960 | TN | |
| Pediatric Radiology Physician | 2085P0229X | ME71982 | FL | Primary |
Addresses
Primary practice location
3100 SW 62ND Ave
Radiology Department
Miami, FL 33155
Mailing address
3100 SW 62ND Ave
Radiology Department
Miami, FL 33155-3009
Phone (305) 662-8392
Other practice location 1
262 Danny Thomas Pl
Memphis, TN 38105-3678
Phone (901) 595-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 257802600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 78.06 of 100
- Quality
- 72.79
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60960 | TN | MD | Neuroradiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Jude Children'S Research Hospital, Inc. | Current | Accepting new patients |
Locations
262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343
Interoperability endpoints
- mballesteros30116@mlh.direct-ci.com
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.
-
- Pediatrics Physician
- Memphis, TN
- NPI 1306335088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710806400000",
"number": "1508897216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"address_2": "RADIOLOGY DEPARTMENT",
"city": "MIAMI",
"state": "FL",
"postal_code": "331553009",
"telephone_number": "305-662-8392",
"fax_number": "305-667-8689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 SW 62ND AVE",
"address_2": "RADIOLOGY DEPARTMENT",
"city": "MIAMI",
"state": "FL",
"postal_code": "33155",
"telephone_number": "305-662-8392",
"fax_number": "305-667-8689"
}
],
"practiceLocations": [
{
"address_1": "262 Danny Thomas Pl",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381053678",
"country_code": "US",
"telephone_number": "901-595-3300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALLESTEROS",
"first_name": "MARTHA",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2024-03-19",
"certification_date": "2024-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "TN",
"license": "60960",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "TN",
"license": "60960",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "FL",
"license": "ME71982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "257802600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.