Individual provider Active NPI

Kalavagunta Sambasiva Satish Balaji, MD

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1902093511
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
002947 Issued in NY
Practice address
8268 164TH St
Queens Hospital Center
Jamaica, NY 11432-1121
Phone
(718) 883-4000
NPI assigned
Sep 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 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 002947 NY Primary

Addresses

Primary practice location

8268 164TH St
Queens Hospital Center
Jamaica, NY 11432-1121

Mailing address

8218 164TH PL
First Floor
Jamaica, NY 11432-1238
Phone (203) 668-2613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160927001986 CA Practitioner - Internal Medicine 4880762285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health PartnersGroup PAC ID 6608280268, 497 clinicians

Practice addresses (Care Compare)

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

45 E River Park PL W
Fresno, CA 93720-1565
Phone (559) 320-0530

Hospital & facility affiliations

  • Community Regional Medical Center Hospital, Fresno, CA, CCN 050060

Merit-based Incentive Payment System (MIPS)

Final score
92.04 of 100Reported as group
Quality
78.62
Promoting interoperability
100
Improvement activities
40
Cost
75.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107157CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Partners CurrentSince Mar 1, 2022 Accepting new patients

Locations

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

45 E River Park Pl W
Ste 104
Fresno, CA 93720
Phone (559) 320-0550

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

805 W Acequia Ave
Ste 2D
Visalia, CA 93291
Phone (559) 622-8687

Organizations & group practices 1

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 1

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": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1902093511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8218 164TH PL",
            "address_2": "FIRST FLOOR",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321238",
            "telephone_number": "203-668-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "address_2": "QUEENS HOSPITAL CENTER",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321121",
            "telephone_number": "718-883-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATISH BALAJI",
        "first_name": "KALAVAGUNTA",
        "middle_name": "SAMBASIVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "002947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.