Individual provider Active NPI

Balasukanya Balaraman, MD

  • Family Medicine Physician
  • Clifton Park, NY
National Provider Identifier
1891815270
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
266285 Issued in NY
Practice address
1 Tallow Wood Dr
Clifton Park, NY 12065-2807
Phone
(518) 373-4500
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 266285 NY Primary

Addresses

Primary practice location

1 Tallow Wood Dr
Clifton Park, NY 12065-2807

Mailing address

PO Box 7247-6822
Philadelphia, PA 19170-0001
Phone (914) 241-1050

Other practice location 1

600 Westage Business Ctr Dr
Fishkill, NY 12524-2281
Phone (845) 231-5600

Other identifiers 1

IdentifierTypeStateIssuer
03496522MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20121025000056 NY Practitioner - Family Practice 0840344115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians
Select PT, OT and SLP Rehabilitation Ny, PLLCGroup PAC ID 3870986656, 261 clinicians

Practice addresses (Care Compare)

1 Tallow Wood Dr
Clifton Park, NY 12065-2807
Phone (518) 688-0295

125 Harry Howard Ave
Hudson, NY 12534-1601
Phone (800) 479-7695

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3554

Hospital & facility affiliations

  • Eddy Visiting Nurse & Rehab Association Home health agency, Troy, NY, CCN 337203
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153
  • Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Optum Medical Care, P.C. CurrentSince Jan 1, 2015 Accepting new patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

1 Tallow Wood Dr
Clifton Park, NY 12065
Phone (518) 373-4444

600 Westage Business Ctr Dr
#D
Fishkill, NY 12524

713 Troy Schenectady Rd
Ste 304
Latham, NY 12110
Phone (518) 373-4448

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: bbalaraman834469@direct.trinity-health.org

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.

Hospital & facility affiliations 5

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1891815270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7247-6822",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191700001",
            "telephone_number": "914-241-1050",
            "fax_number": "914-242-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TALLOW WOOD DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652807",
            "telephone_number": "518-373-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Westage Business Ctr Dr",
            "address_purpose": "LOCATION",
            "city": "Fishkill",
            "state": "NY",
            "postal_code": "125242281",
            "country_code": "US",
            "telephone_number": "845-231-5600",
            "fax_number": "845-231-5489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALARAMAN",
        "first_name": "BALASUKANYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "266285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03496522",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP- Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1 Tallow Wood Dr",
            "city": "Clifton Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "120652807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.