Carlos Enrique Ballestas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME110974 Issued in FL

Practice address

12651 W Sunrise Blvd Ste 202
Sunrise, FL 33323-0906

Phone

(954) 838-8801

Fax

(954) 838-8807

NPI assigned

Jun 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family PracticeAlso: Geriatric Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

East Florida Primary Care LLCGroup PAC ID 7315091899, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmccballe@yourcarecommunity.org

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.

• East Florida Primary Care LLC

  • Family Medicine Physician
  • Sunrise, FL
  • NPI 1811121205
  Medicare reassignment Care Compare group NPD
• Palm Beach General Surgery LLC

  • Surgery Physician
  • Atlantis, FL
  • NPI 1710040266
  NPD (past)
• Canadian River Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Dumas, TX
  • NPI 1790734515
  NPD (past)
• Topcare Medical PA

  • Specialist
  • Irving, TX
  • NPI 1043231400
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1609812437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12651 W SUNRISE BLVD STE 202",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333230906",
            "telephone_number": "954-838-8801",
            "fax_number": "954-838-8807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12651 W SUNRISE BLVD STE 202",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333230906",
            "telephone_number": "954-838-8801",
            "fax_number": "954-838-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTAS",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-02-10",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M2549",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME110974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1791238-02",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CARLOS.BALLESTAS@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12651 W Sunrise Blvd Ste 202",
            "city": "Sunrise",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333230906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Junar Dasal Balaoing, PT
• Laszlo Balazs, MD
• Anthony F Baldocchi, STUDENT
• Junalyn Ducducan Baligasa
• Dhruv R. Balkundi, MD
• Reigna Paula Felix Balmaceda, PTRP, RPT
• Dina Decosta Bank, MS, CCC-SLP
• Andrea Bauer Banta, CRN
• Baptist Health Urgent Care Sawgrass
• Baptist Surgery and Endoscopy Centers LLC

• Family Medicine Physician in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.

Verify at the official NPI Registry.