NPIMap

Individual provider Active NPI

Ahmad Bali, MD

  • Surgery Physician
  • Charleston, WV
National Provider Identifier
1689670069
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
21044 Issued in WV
Practice address
400 S Ruffner Rd Ste 2
Charleston, WV 25314-1542
Phone
(304) 346-2254
Fax
(304) 346-3184
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 21044 WV
Surgery Physician 208600000X 21044 WV Primary

Addresses

Primary practice location

400 S Ruffner Rd Ste 2
Charleston, WV 25314-1542

Mailing address

400 S Ruffner Rd Ste 2
Charleston, WV 25314-1542
Phone (304) 346-2254

Other identifiers 3

IdentifierTypeStateIssuer
2535813MedicaidOH
1812616001MedicaidWV
64058845MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20040311000064 WV Practitioner - General Surgery 7517856487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Court St
Suite 203
Charleston, WV 25301-1653
Phone (304) 346-2254

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21044WVMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael M Boustany MD Inc Surgery Past 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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1689670069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S RUFFNER RD STE 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141542",
            "telephone_number": "304-346-2254",
            "fax_number": "304-346-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S RUFFNER RD STE 2",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253141542",
            "telephone_number": "304-346-2254",
            "fax_number": "304-346-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALI",
        "first_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WV",
            "license": "21044",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "21044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2535813",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1812616001",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64058845",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.