Individual provider Active NPI

Robert Balthazar, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1871661405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
232735 Issued in NY
Practice address
234 E 149TH St
(149TH Street)
Bronx, NY 10451-5504
Phone
(718) 579-5000
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 232735 NY Primary

Addresses

Primary practice location

234 E 149TH St
(149TH Street)
Bronx, NY 10451-5504

Mailing address

7 Fletcher CT
Spring Valley, NY 10977-2304
Phone (845) 371-1020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050124000884 NY Practitioner - Internal Medicine 1254381668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Casa de Salud IncGroup PAC ID 6103913835, 23 clinicians

Practice addresses (Care Compare)

754 E 151St St
Bronx, NY 10455-3267
Phone (347) 352-2484

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232735NYMDInternal Medicine Physician

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
La Casa de Salud, Inc CurrentSince Apr 20, 2015 Accepting new patients
La Casa de Salud Inc. Current Accepting new patients
Lincon Medical and Mental Center Past Accepting new patients
Downtown Bronx Medical Associates PC Past Accepting new patients

Locations

324 E 149th St
Bronx, NY 10451
Phone (718) 665-4300

966 Prospect Ave
Bronx, NY 10459
Phone (718) 617-6060

754 E 151st St
Bronx, NY 10455
Phone (347) 352-2500

915 Westchester Ave
Bronx, NY 10459
Phone (646) 224-9300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871661405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FLETCHER CT",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109772304",
            "telephone_number": "845-371-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E 149TH ST",
            "address_2": "(149TH STREET)",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515504",
            "telephone_number": "718-579-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTHAZAR",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "232735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.