Individual provider Active NPI

Cynthia Laverty Ballesteros, M.D.

  • Family Medicine Physician
  • Denton, TX
National Provider Identifier
1598057473
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q3223 Issued in TX
Practice address
3751 S I 35 E
Denton, TX 76210-6852
Phone
(940) 383-2700
Fax
(940) 383-7640
NPI assigned
May 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01081615A IN
Family Medicine Physician 207Q00000X 2019-00095 NC
Family Medicine Physician 207Q00000X 0101266203 VA
Family Medicine Physician 207Q00000X Q3223 TX Primary

Addresses

Primary practice location

3751 S I 35 E
Denton, TX 76210-6852

Mailing address

PO Box 9101
Coppell, TX 75019-9494
Phone (940) 383-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200406002788 TX Practitioner - Family Practice 2567715097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01081615AINMDFamily Medicine Physician
2019-00095NCMDFamily Medicine Physician
0101266203VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Physicians, PLLC PastSince Aug 24, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1598057473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9101",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750199494",
            "telephone_number": "940-383-2700",
            "fax_number": "940-383-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 S I 35 E",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106852",
            "telephone_number": "940-383-2700",
            "fax_number": "940-383-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERTY BALLESTEROS",
        "first_name": "CYNTHIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01081615A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-00095",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101266203",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q3223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.