Angela Balcom

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN10013081 Issued in MA

Practice address

310 Broadway
Revere, MA 02151-5035

Phone

(781) 289-2266

NPI assigned

Jul 24, 2024

Last updated

Dec 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abalcom132142@tuftsmedicine.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hallmark Health Medical Associates Inc

  • Family Medicine Physician
  • Medford, MA
  • NPI 1770563900
  Medicare reassignment Care Compare group NPD
• Pratt OB/GYN Associates, Inc

  • Obstetrics & Gynecology Physician
  • Boston, MA
  • NPI 1336186501
  NPD (past)

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1831927466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 QUINNIPIAC AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065134007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BROADWAY",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515035",
            "telephone_number": "781-289-2266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Quinnipiac Ave",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065134007",
            "country_code": "US",
            "telephone_number": "203-503-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALCOM",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN10013081",
            "primary": true
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "MA",
            "license": "RN10013081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phalnarith Ba, OUT REACH WORKER
• Boris Bacanurschi, D.M.D.
• Danielle Badolato, NP
• Driss Bahraoui
• Joanne Bairos, PHARMD, RPH
• Bao Min Yee DMD
• Bao Min Yee, DMD PC
• Joyce Barksdale
• Joanna Barnas, PHARMACIST
• Kathleen Noelle Barnum, PHARMD

• Women's Health Nurse Practitioner in Revere, MA
• Providers in Revere, MA by specialty
• Women's Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.