DR. PRASHANT BALIGA M.D.
NPI 1013114305
Internal Medicine in Thomasville, GA

Q: What is Prashant Baliga's NPI number?

The NPI number for Prashant Baliga is 1013114305. It was assigned to this individual provider in the NPPES registry on June 29, 2007.

Q: What is Prashant Baliga's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Prashant Baliga was last updated on March 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 29, 2007PECOS EnrolledAccepts Medicare Assignment

915 GORDON AVE, THOMASVILLE, GA 31792(229) 228-8575 Get Directions Write a Review

NPPES record last updated: March 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Prashant Baliga M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRASHANT BALIGA M.D. (NPI 1013114305) is an individual internal medicine provider in Thomasville, Georgia, licensed in Florida (ME122015) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Archbold Memorial, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1013114305

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. PRASHANT BALIGACredential: M.D.

Location Address915 GORDON AVEThomasville, GA 31792-6614

Mailing Address2801 Chancellorsville Dr, Apt 118Tallahassee, FL 32312-4815 · (989) 906-2397

Phone(229) 228-8575

Sole ProprietorYes

Medical School CMSOtherGraduated 2004

Enumeration DateJune 29, 2007

Last NPPES UpdateMarch 11, 2022

NPPES CertifiedMarch 11, 2022

✔ NPI 1013114305 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in FL · ME122015✔ Licensed in GA · 64756

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

915 GORDON AVE, Thomasville, GA 31792

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Prashant Baliga M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335336072

PECOS Enrollment IDI20101208000009

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

417 services180 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

287 services119 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

146 services139 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

78 services76 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

22 services22 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

17 services16 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Archbold Memorial

Acute Care Hospitals · Thomasville, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110038

Location915 Gordon Avenue & Mimosa DriveThomasville, GA 31792 · Thomas County

Emergency services Birthing friendly

Memorial Hospital And Manor

Acute Care Hospitals · Bainbridge, GA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110132

Location1500 E Shotwell StreetBainbridge, GA 39819 · Decatur County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31792 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON GRACE MAXWELL NP

Nurse Practitioner (Family)