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DR. AJAY K BALARAM MD
NPI 1013171636
Orthopaedic Surgery - Hand Surgery in Arlington Heights, IL

Active since July 13, 2008PECOS EnrolledAccepts Medicare Assignment
515 W ALGONQUIN RD, ARLINGTON HEIGHTS, IL 60005(847) 956-0099(847) 956-0099 Get Directions Write a Review

NPPES record last updated: November 11, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Ajay K Balaram Md NPPES

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

DR. AJAY K BALARAM MD (NPI 1013171636) is an individual hand surgery provider in Arlington Heights, Illinois, licensed in Illinois (036.123743) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Northwest Community Hospital 1, and is a graduate of Creighton University School Of Medicine (2006).

NPPES Registry Identity

NPI1013171636
Entity TypeIndividualMale
Primary Taxonomy207XS0106X
Provider Legal NameDR. AJAY K BALARAMCredential: MD
Location Address515 W ALGONQUIN RDArlington Heights, IL 60005-4439
Mailing Address515 W Algonquin RdArlington Heights, IL 60005-4439 · (847) 956-0099 · Fax (847) 956-0099
Phone(847) 956-0099
Fax(847) 956-0099
Sole ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 2006
Enumeration DateJuly 13, 2008
Last NPPES UpdateNovember 11, 2012
✔ NPI 1013171636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic Surgery · Hand SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207XS0106X
License✔ Licensed in IL · 036.123743
Definition
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 125051809 (IL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 261302 (NY)
515 W ALGONQUIN RD, Arlington Heights, IL 60005
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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. Ajay K Balaram Md 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 ID1658517529
PECOS Enrollment IDI20130419000085
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 11

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.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
189 services29 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
125 services81 patients
X-ray of wrist, minimum of 3 views 73110
An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
99 services47 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
99 services70 patients
X-ray of finger, minimum of 2 views 73140
An X-ray of the finger involves capturing images of your finger from at least two different angles. This non-invasive procedure helps in visualizing the bones and joints, aiding in the diagnosis of fractures, infections, or other abnormalities. Minimal discomfort may be experienced.
50 services32 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
45 services45 patients

Hospital Affiliations CMS Care Compare 2

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

Northwest Community Hospital 1

Acute Care Hospitals · Arlington Heights, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140252
Location800 W Central RoadArlington Heights, IL 60005 · Cook County
Emergency services Birthing friendly

Alexian Brothers Medical Center 1

Acute Care Hospitals · Elk Grove Village, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140258
Location800 Biesterfield RdElk Grove Village, IL 60007 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60005 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
79%2,967 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%171 patients5/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
42%550 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
63%976 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
25%896 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
85%976 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%976 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 225 patients
0%225 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
6%976 patients
Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.
83%53 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment L3913
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$205.75 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

ILLINOIS HAND & UPPER EXTREMITY CENTER, L.L.C.
Clinic/Center (Ambulatory Surgical)
515 W ALGONQUIN RD
ARLINGTON HEIGHTS, IL 60005
Cook County (847) 956-0099
JOHN R RUDER MD
Orthopaedic Surgery (Hand Surgery)
515 W ALGONQUIN RD, SUITE 120
ARLINGTON HEIGHTS, IL 60005
Cook County (847) 956-0099
MS. MICHELLE R MICHALSKI
Occupational Therapist
515 W ALGONQUIN RD, SUITE 110
ARLINGTON HEIGHTS, IL 60005
Cook County (847) 956-0099
HALINA BEDNARZ OTR/L
Occupational Therapist
515 W ALGONQUIN RD
ARLINGTON HEIGHTS, IL 60005
Cook County (847) 956-0388
GARY S SOLOMON
Occupational Therapist (Hand)
515 W ALGONQUIN RD, SUITE 110
ARLINGTON HEIGHTS, IL 60005
Cook County (847) 956-0388
CHICAGO MEDICAL SERVICES LLC
Occupational Therapist (Hand)
515 W ALGONQUIN RD, STE 110
ARLINGTON HTS, IL 60005
Cook County (847) 956-0388
JONAH B WETHERILL OTR L
Occupational Therapist (Hand)
515 W ALGONQUIN RD, SUITE 120
ARLINGTON HEIGHTS, IL 60005
Cook County (847) 956-0388
HAND SURGERY ASSOCIATES SC
Orthopaedic Surgery (Hand Surgery)
515 W ALGONQUIN RD, SUITE 120
ARLINGTON HTS, IL 60005
Cook County (847) 956-0099

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ajay Balaram's NPI number?

The NPI number for Ajay Balaram is 1013171636. It was assigned to this individual provider in the NPPES registry on July 13, 2008.

Where is Ajay Balaram located?

Ajay Balaram practices at 515 W Algonquin Rd, Arlington Heights, IL 60005. The listed phone number is (847) 956-0099.

What is Ajay Balaram's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Hand Surgery, with taxonomy code 207XS0106X.

Is Ajay Balaram enrolled in Medicare?

Yes. Ajay Balaram is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Ajay Balaram affiliated with any hospitals?

According to CMS data, Ajay Balaram is affiliated with Northwest Community Hospital 1 and Alexian Brothers Medical Center 1.

When was this NPI record last updated?

The NPPES record for Ajay Balaram was last updated on November 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.