Carmen S Balding, MD
Individual provider Active NPI MOHS-Micrographic Surgery Physician · Glendale, WI
NPI 1811095342 · NPPES record last updated Nov 7, 2016
Key facts
- NPI
- 1811095342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- MOHS-Micrographic Surgery Physician 207ND0101X
- License
- 47048 (WI)
- Practice address
- 375 W. River Woods Prkwy
Glendale, WI 53212 - Phone
- (414) 326-1514
- Fax
- (414) 326-1574
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Madison Medical Affiliates Inc
Practice addresses (Care Compare)
22370 W Bluemound Rd
Suite 200
Waukesha, WI 53186-1683
Phone (262) 574-9920
Hospital & facility affiliations
- Ascension Columbia St Marys Hospital Milwaukee
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 130 |
| Removal of skin lesions | 29 |
| Removal of skin cancer | 470 |
| Skin biopsy | 73 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041013001297 | WI | Practitioner - Dermatology | 0446210405 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47048 | WI | MD | MOHS-Micrographic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical College of Wisconsin, Inc. | Dermatology | Current |
Accepting new patients |
| Madison Medical Affiliates, Inc. | Current |
Accepting new patients |
Locations
7423 Solutions Ctr
Chicago, IL 60677
375 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 326-1500
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
13133 N Port Washington Rd
Ste G01
Mequon, WI 53097
Phone (262) 243-2500
12831 N Port Washington Rd
Mequon, WI 53097
Phone (262) 643-1300
788 N Jefferson St
Ste 300
Milwaukee, WI 53202
Phone (414) 272-8950
788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Interoperability endpoints
- https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 47048 | WI | |
| MOHS-Micrographic Surgery Physician | 207ND0101X | 47048 | WI | Yes |
Addresses
Primary practice location
375 W. River Woods Prkwy
Glendale, WI 53212
Mailing address
788 N. Jefferson Street
Suite 300 / Attn. Kaaren Butzen
Milwaukee, WI 53202-3710
Phone (414) 272-8950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811095342 | Medicaid | WI |
Other names
- Carmen S Mansilla-Orihuela
Other providers in Glendale, WI
- Baby Fever LLC
- Babynme LLC
- Andrew R Bagley
- Nicole C. Bailke
- Colleen W Baird
- Ramadevi Balija
- Geraldine B Banks
- Randi Lynn Bartels
- Bayshore Vision, LLC
- Michelle Kristie Beahm
All providers in Glendale, WI · MOHS-Micrographic Surgery Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.