NPIMap

Individual provider Active NPI

Balkissoon Maharajh, MD

  • Internal Medicine Physician
  • Johnstown, PA
National Provider Identifier
1679559272
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD051194L Issued in PA
Practice address
1015 Franklin St
Level a
Johnstown, PA 15905
Phone
(814) 536-9715
Fax
(814) 539-6138
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD051194L PA Primary

Addresses

Primary practice location

1015 Franklin St
Level a
Johnstown, PA 15905

Mailing address

1015 Franklin St
Level a
Johnstown, PA 15905
Phone (814) 536-9715

Other identifiers 1

IdentifierTypeStateIssuer
0014267380003MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bala1@balkissonmaharajh.medentdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000003 PA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 4981622107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banmaha PCGroup PAC ID 2466414586, 2 clinicians
Vantage Physical Therapy and Rehabilitation IncGroup PAC ID 3072424886, 253 clinicians

Practice addresses (Care Compare)

1015 Franklin St
Level a
Johnstown, PA 15905-4110
Phone (814) 536-9715

336 Bloomfield St
Johnstown, PA 15904-3271
Phone (814) 269-2224

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banmaha PC Internal Medicine CurrentSince Nov 1, 2001 Accepting new patients
DLP Conemaugh Memorial Medical Center LLC Past Accepting new patients
Hilltop Heights Health & Rehab Center, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

100 Woodmont Rd
Johnstown, PA 15905
Phone 412963915010149

1111 Franklin St
Ste 220
Johnstown, PA 15905
Phone (814) 534-3279

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

1015 Franklin St
Fl A
Johnstown, PA 15905

Organizations & group practices 6

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1679559272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 FRANKLIN ST",
            "address_2": "LEVEL A",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15905",
            "telephone_number": "814-536-9715",
            "fax_number": "814-539-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 FRANKLIN ST",
            "address_2": "LEVEL A",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15905",
            "telephone_number": "814-536-9715",
            "fax_number": "814-539-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHARAJH",
        "first_name": "BALKISSOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD051194L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014267380003",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bala1@balkissonmaharajh.medentdirect.com",
            "affiliation": "N",
            "address_1": "1015 Franklin St",
            "address_2": "Level A",
            "city": "Johnstown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "15905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.