Individual provider Active NPI

Timothy James Balling, M.D.

  • Emergency Medicine Physician
  • Brandon, FL
National Provider Identifier
1902861966
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00022749 Issued in AL
Practice address
119 Oakfield Dr
Brandon, FL 33511-5779
Phone
(813) 571-5150
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00022749 AL Primary
Emergency Medicine Physician 207P00000X ME95813 FL

Addresses

Primary practice location

119 Oakfield Dr
Brandon, FL 33511-5779

Mailing address

3025 Marble Crest Dr
Land O Lakes, FL 34638-6081
Phone (813) 949-5209

Other identifiers 3

IdentifierTypeStateIssuer
275628500MedicaidFL
U8519VOtherFLMEDICARE
U8519XOtherFLMEDICARE

Medicare participation

Medicare enrollment files
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061205000093 FL Practitioner - Emergency Medicine 0749289528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of South Florida College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Associates of Tampa Bay LLCGroup PAC ID 3678746674, 84 clinicians

Practice addresses (Care Compare)

4211 Van Dyke Rd
Lutz, FL 33558-8005
Phone (813) 443-7000

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00022749ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Medical Group LLC Emergency Medicine CurrentSince Apr 1, 2016 Accepting new patients
Observation Medical Group LLC Emergency Medicine CurrentSince Apr 1, 2016 Accepting new patients
Emergency Medical Associates of Tampa Bay, LLC Emergency Medicine CurrentSince Dec 1, 2011 Accepting new patients

Locations

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

2502 W Saint Isabel St
Tampa, FL 33607
Phone (813) 874-5707

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

4501 Bruce B Downs Blvd
Wesley Chapel, FL 33544
Phone (813) 870-4000

Organizations & group practices 3

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 2

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1902861966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 MARBLE CREST DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346386081",
            "telephone_number": "813-949-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779",
            "telephone_number": "813-571-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLING",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00022749",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME95813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275628500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "U8519V",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "U8519X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.