Active NPI
Dania Ballich, M.D.
- Internal Medicine Physician
- St. Petersburg, FL
National Provider Identifier
1689201535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME163452
- Practice address
- 1839 Central Ave
St. Petersburg, FL 33713-8900 - Phone
- (727) 322-1054
- Fax
- (727) 821-7213
- NPI assigned
- Mar 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | ME163452 | FL | |
| Internal Medicine Physician | 207R00000X | ME163452 | FL | Primary |
Addresses
Primary practice location
1839 Central Ave
St. Petersburg, FL 33713-8900
Mailing address
1839 Central Ave
St. Petersburg, FL 33713-8900
Phone (727) 322-1054
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122518200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240612004317 | FL | Practitioner - Internal Medicine | 9032651476 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1839 Central Ave
St Petersburg, FL 33713-9089
Phone (727) 322-1054
Hospital & facility affiliations
- Suncoast Hospice
- Pinellas Park FL Opco, LLC
- Harbourwood Post-Acute and Rehabilitation Center
- Boca Ciega Center
- Aviata at Seminole
- Palm Garden of Pinellas
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME163452 | FL | MD | Hospice and Palliative Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Health Care of Pinellas LLC | Internal Medicine | Current | Accepting new patients |
| Professional Health Care of Pinellas Inc. | Current | Accepting new patients |
Locations
1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054
6336 Fort King Rd
Zephyrhills, FL 33542
Phone (813) 640-0060
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIJHAA
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.
-
- Internal Medicine Physician
- St Petersburg, FL
- NPI 1881647253
FL, Internal Medicine
-
- Chiropractor
- St Petersburg, FL
- NPI 1568970903
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Skilled Nursing Facility
- Gulfport, FL
- NPI 1720082688
Nursing home
-
- Community Based Hospice Care Agency
- Palm Harbor, FL
- NPI 1124028204
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1689201535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 CENTRAL AVE",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "337138900",
"telephone_number": "727-322-1054",
"fax_number": "727-821-7213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1839 CENTRAL AVE",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "337138900",
"telephone_number": "727-322-1054",
"fax_number": "727-821-7213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLICH",
"first_name": "DANIA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-23",
"last_updated": "2024-06-26",
"certification_date": "2020-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "FL",
"license": "ME163452",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME163452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122518200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St. Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.