Carmen S Ballestas, M.D.

Primary specialty

Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X

License

ME110936 Issued in FL

Practice address

1150 N 35TH Ave Ste 100
Hollywood, FL 33021

Phone

(954) 265-2234

Fax

(954) 985-2288

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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.

• South Broward Hospital District

  • Critical Care Medicine (Internal Medicine) Physician
  • Hollywood, FL
  • NPI 1609884154

  FL

  Medicare reassignment NPD
• South Broward Hospital District

  • Surgery Physician
  • Hollywood, FL
  • NPI 1043598840
  NPD
• South Broward Hospital District

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD
• South Broward Hospital District

  • Pediatric Orthopaedic Surgery Physician
  • Hollywood, FL
  • NPI 1407865520
  NPD (past)

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cballestas79092@mhsdirect.net

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2021.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1871667048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 100",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-265-2234",
            "fax_number": "954-985-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLESTAS",
        "first_name": "CARMEN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "FL",
            "license": "ME110936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004186500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cballestas79092@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1150 N 35th Ave Ste 100",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark William Baldwin, L.C.S.W.
• Rebecca Balgley, MSW
• Richard Lee Balick, DMD
• Bonnie Balk, RD
• Baldath Balkaran, RPH
• Julio Ballestas, M.D
• Yania Ballesteros Orive, RBT-1987282
• Bamboo Counseling Services, LLC
• Latoyia Samanthiea Banks
• Yehuda Bar Zvi, M.D.

• All providers in Hollywood, FL
• Pediatric Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.