JILLANN M BALKO CRNA NPI 1013090216
Nurse Anesthetist, Certified Registered in Morgantown, WV

About JILLANN M BALKO CRNA

Jillann Balko is a provider established in Morgantown, West Virginia and her medical specialization is Nurse Anesthetist, Certified Registered with more than 28 years of experience. The NPI number of Jillann Balko is 1013090216 and was assigned on October 2006. The practitioner's primary taxonomy code is 367500000X with license number 50514 (WV). The provider is registered as an individual and her NPI record was last updated 15 years ago.

NPI
1013090216
Provider Name JILLANN M BALKO CRNA
Location Address1200 J D ANDERSON DR MORGANTOWN, WV 26505
Location Phone(304) 598-4000
Mailing AddressPO BOX 711841 COLUMBUS, OH 43271
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year1995
Is Sole Proprietor?No
Enumeration Date10-23-2006
Last Update Date05-08-2008

Jillann Balko is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.6, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.46 for a new patient copayment and $24.74 for an established patient copayment.



Primary Taxonomy

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Taxonomy Code367500000X
ClassificationNurse Anesthetist, Certified Registered
TypePhysician Assistants & Advanced Practice Nursing Providers
License No.50514
License StateWV
Taxonomy Description(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

Accepted Insurance

The NPI profile data indicates this provider might be enrolled and accepting insurance plans from the following companies or healthcare programs:

  • Blue Cross Blue Shield
  • Medicaid
  • Medicare
  • Railroad Medicare
  • Tricare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Business Address

JILLANN M BALKO CRNA
1200 J D ANDERSON DR
MORGANTOWN, WV
ZIP 26505
Phone: (304) 598-4000
Fax: (304) 293-6963

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Mailing Address

JILLANN M BALKO CRNA
PO BOX 711841
COLUMBUS, OH
ZIP 43271
Phone: (304) 346-9400
Fax: (304) 720-8461


Location Map

PECOS Enrollment and Medicare Participation Status

What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.

PECOS PAC ID840278487
PECOS Enrollment IDI20040710000192
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

Physician Office Visit Costs

The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 26505 ZIP code area.

New Patients Office Visits Costs *
Most Utilized Procedure Code for new patients office visits: 99203
Minimum New Patient Pricing Maximum New Patient Pricing Typical New Patient Pricing
$55.31 $170.81 $85.84
Minimum New Patient Copayment Maximum New Patient Copayment Typical New Patient Copayment
$13.82 $42.7 $21.46
Established Patients Office Visits Costs *
Most Utilized Procedure Code for established patients office visits: 99214
Minimum Established Patient Pricing Maximum Established Patient Pricing Typical Established Patient Pricing
$16.61 $138.83 $98.99
Minimum Established Patient Copayment Maximum Established Patient Copayment Typical Established Patient Copayment
$4.15 $34.7 $24.74

* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

MIPS Measure Score Weight Score
Quality 40% 100
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability (PI) 25% 70
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities 15% 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost 20% N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
MIPS Final Score - 94.6
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 17Anesthesia for procedure on lower intestine using an endoscope (HCPCS:00810)
  • 11Anesthesia for lens surgery (HCPCS:00142)
  • 11Anesthesia for procedure on gastrointestinal tract using an endoscope (HCPCS:00740)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jillann Balko is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
WEST VIRGINIA UNIVERSITY HOSPITALS1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
(304) 598-4200Acute Care Hospitals510001

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2601027000MEDICAID (05)WV
001720735OTHER (01)WVMT STATE BCBS
DA0096OTHER (01)WVRR MEDICARE
27005299701OTHER (01)WVWORKERS COMP
8227222MEDICARE PIN (08)WV
001706470OTHER (01)WVMSBSBS
270052997004OTHER (01)WVTRICARE
0207026000MEDICAID (05)WV
P00207323OTHER (01)WVRR MEDICARE
27005299701OTHER (01)WVBRICKSTREET
9333201MEDICARE PIN (08)WV

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1013090216
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
202309022
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 2 + 3 + 0 + 9 + 0 + 2 + 2 + 24 = 44
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 44 = 66

The NPI number 1013090216 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1679548242 RICHARD FRANKLIN MORTON CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 285-1200
1578522637 SARA A MORELAND CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR MONONGALIA GENERAL HOSPITAL
MORGANTOWN, WV 26505
(304) 346-9400
1922068188DR. STEPHANY S SWART M.D.
Individual
Radiology (Diagnostic Radiology)1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 285-6695
1588604722 MARY ANN CLARKE CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1200
1467493908 PATRICIA K MORRIS CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1200
1053352369 LORI A RIZOR CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR MONONGALIA GENRAL HOSPITAL
MORGANTOWN, WV 26505
(304) 285-1245
1093747164 BONAVENTURE J PORCO CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 243-3343
1285740159 ELIZABETH A LEWIS D.O.
Individual
Anesthesiology1200 J D ANDERSON DR MID ATLANTIC ANESTHESIA CONSULTANTS, PLLC
MORGANTOWN, WV 26505
(304) 346-9400
1093815375 APRIL J LOMBARDO
Individual
Registered Nurse (Diabetes Educator)1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1299
1760577027 RUBY NIEVES DELAMATA M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1560
1366530685 CARL A WHEELER CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 285-1200
1578648663 ELSA F WEST CRNA
Individual
Nurse Anesthetist, Certified Registered1200 J D ANDERSON DR MONONGALIA GENERAL HOSPITAL
MORGANTOWN, WV 26505
(304) 285-1200
1881731313 ELIZABETH SEMMENS RD LD
Individual
Dietitian, Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1560
1962549493 LAURIE DAILEY MNT
Individual
Dietitian, Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1560
1497892921 BRENDA S TURNER RD, LD
Individual
Dietitian, Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1560
1841337375 MELINDA WEAVER MNT
Individual
Dietitian, Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1560
1659418093 LORI ANN BAKER
Individual
Dietitian, Registered1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1560
1275659286MS. SUSAN HELEN SARGUT R.PH
Individual
Pharmacist1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1444
1336260090 TIMOTHY W HARDWICK PHYSICAL THERAPIST
Individual
Physical Therapist1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1471
1346361011 PAMELA S TAYLOR PHYSICAL THERAPIST
Individual
Physical Therapist1200 J D ANDERSON DR
MORGANTOWN, WV 26505
(304) 598-1471

Frequently Asked Questions

What is Jillann Balko CRNA NPI number?

The NPI number assigned to Jillann Balko CRNA is 1013090216, registered as an "individual" on October 23, 2006

Where is Jillann Balko CRNA located?

The provider is located at 1200 J D Anderson Dr Morgantown, Wv 26505 and the phone number is (304) 598-4000

Which is Jillann Balko CRNA specialty?

The provider's speciality is Nurse Anesthetist, Certified Registered

How many years of experience does Jillann Balko CRNA have?

The provider has more than 28 years of experience.

What insurance does Jillann Balko CRNA accept?

The provider might be accepting Blue Cross Blue Shield, Medicaid, Medicare, Railroad Medicare and Tricare. Please consult your insurance carrier or call the provider to make sure your insurance plan is currently accepted.

How much is a visit to Jillann Balko CRNA?

Medicare beneficiaries should expect a typical cost of $85.84 with an average copayment of $21.46 for new patient appointments. Established patients should expect a typical charge of $98.99 and an average copayment of 24.74. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Jillann Balko CRNA?

The most common procedures or services performed by this practitioner are: Anesthesia for procedure on lower intestine using an endoscope, Anesthesia for lens surgery and Anesthesia for procedure on gastrointestinal tract using an endoscope.

Is Jillann Balko CRNA affiliated to any hospitals?

The practitioner is affiliated to the following hospitals: WEST VIRGINIA UNIVERSITY HOSPITALS. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

The NPI record of Jillann Balko CRNA was last updated on October 23, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us at: [email protected]