Individual provider Active NPI

Ryan Patrick Balogh, M.D.

  • Surgery Physician
  • Grapevine, TX
National Provider Identifier
1891013652
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
Q4897 Issued in TX
Practice address
1650 W. College Street, Box # 54
Baylor Scott & White Grapevine, Attn Trauma Services
Grapevine, TX 76051-3565
Phone
(817) 388-3600
Fax
(817) 388-3610
NPI assigned
May 4, 2010
Last updated
Nov 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Q4897 TX Primary

Addresses

Primary practice location

1650 W. College Street, Box # 54
Baylor Scott & White Grapevine, Attn Trauma Services
Grapevine, TX 76051-3565

Mailing address

P.O. Box 961205
Fort Worth, TX 76116-1205
Phone (817) 740-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151111000806 TX Practitioner - General Surgery 7012227697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at Houston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

1650 W College St Box
54 Baylor Scott and White Grapevine Trauma SV
Grapevine, TX 76051-3565
Phone (817) 338-3600

Hospital & facility affiliations

Procedures performed for Medicare patients

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q4897TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Surgery CurrentSince Nov 1, 2015 Accepting new patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Texas Health Care, P.L.L.C. Surgery CurrentSince Nov 1, 2015 Accepting new patients
Texas Health Care, P.L.L.C. Past Accepting new patients
Baylor Regional Medical Center at Grapevine Past Accepting new patients

Locations

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

1650 W College St
#54
Grapevine, TX 76051
Phone (817) 338-3600

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1891013652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761161205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-378-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W. COLLEGE STREET, BOX # 54",
            "address_2": "BAYLOR SCOTT & WHITE GRAPEVINE, ATTN TRAUMA SERVICES",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513565",
            "telephone_number": "817-388-3600",
            "fax_number": "817-388-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOGH",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-04",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q4897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.