NPIMap

Individual provider Active NPI

Viktor Ballada, M.D.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Saint Louis, MO
National Provider Identifier
1972543460
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
2013007023 Issued in MO
Practice address
10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128-2197
Phone
(314) 525-1798
Fax
(314) 525-4469
NPI assigned
Jun 7, 2006
Last updated
Nov 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 016912 ME
Internal Medicine Physician 207R00000X 2013007023 MO
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 2013007023 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd
Ste 406
Saint Louis, MO 63128-2197
Phone (314) 525-1798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130412000603 MO Practitioner - Preventive MedicinePractitioner - Internal Medicine 1456371871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive MedicineAlso: Internal Medicine
Education
University of Vermont College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Specialists of St Lukes LLCGroup PAC ID 1557366960, 77 clinicians

Practice addresses (Care Compare)

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 966-9100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue727
Removal of skin lesions30

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of St. Luke's, LLC Internal Medicine Past Accepting new patients
Mercy Hospital Past Accepting new patients
Mercy Hospital Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1972543460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1798",
            "fax_number": "314-525-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "STE 406",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-525-1798",
            "fax_number": "314-525-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLADA",
        "first_name": "VIKTOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "016912",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2013007023",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "MO",
            "license": "2013007023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.