DR. KAREN BALONZE MD
NPI 1023360203
Internal Medicine in Fair Lawn, NJ

Q: What is Karen Balonze's NPI number?

The NPI number for Karen Balonze is 1023360203. It was assigned to this individual provider in the NPPES registry on October 11, 2012.

Q: What is Karen Balonze'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 Karen Balonze was last updated on July 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since October 11, 2012PECOS EnrolledAccepts Medicare Assignment

31-00 BROADWAY, FAIR LAWN, NJ 07410(201) 796-2255(201) 796-7020 Get Directions Write a Review

NPPES record last updated: July 9, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 9, 2019, Feb 19, 2016 (2 updates tracked since 2016).

On this page

About Dr. Karen Balonze Md NPPES

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

DR. KAREN BALONZE MD (NPI 1023360203) is an individual internal medicine provider in Fair Lawn, New Jersey, licensed in New Jersey (25MA09427400) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and is a graduate of Rutgers R W Johnson Medical School (cam/new Bruns/pisc) (2011).

NPPES Registry Identity

NPI1023360203

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. KAREN BALONZECredential: MD

Location Address31-00 BROADWAYFair Lawn, NJ 07410-3963

Mailing Address31-00 BroadwayFair Lawn, NJ 07410-3963 · (201) 796-2255

Phone(201) 796-2255

Fax(201) 796-7020

Sole ProprietorNo

Medical School CMSRutgers R W Johnson Medical School (cam/new Bruns/pisc)Graduated 2011

Enumeration DateOctober 11, 2012

Last NPPES UpdateJuly 9, 20192 updates tracked since enumeration

✔ NPI 1023360203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NJ · 25MA09427400

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.

31-00 BROADWAY, Fair Lawn, NJ 07410

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Karen Balonze 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 ID7911203674

PECOS Enrollment IDI20160308000129

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.

Medicare Billing Reassignment

Medicare enrollment records show Karen Balonze reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Summit Medical Group PA

23 mi

Multi-Specialty

1 DIAMOND HILL RD, SUMMIT MEDICAL GROUP
Berkeley Heights, NJ 07922

Reassigned Medicare billing, New Jersey enrollment
1,184 clinicians in this Medicare group

NPI 1942254347 (908) 273-4300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

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.

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.

262 services121 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

91 services69 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

85 services85 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

77 services65 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

68 services59 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

63 services55 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

49 services44 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

42 services32 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

41 services40 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

28 services27 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

26 services26 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

22 services17 patients

Urine microalbumin (protein) level 82043

The urine microalbumin level test measures the amount of a protein called albumin in your urine. This test helps to detect early signs of kidney damage. High levels of albumin may suggest your kidneys aren't functioning properly. It's a simple, non-invasive test that involves providing a urine sample.

21 services17 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

19 services19 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

19 services19 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

18 services18 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.

15 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310001

Location30 Prospect AveHackensack, NJ 07601 · Bergen County

Emergency services Birthing friendly

Holy Name Medical Center

Acute Care Hospitals · Teaneck, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310008

Location718 Teaneck RdTeaneck, NJ 07666 · Bergen County

Emergency services Birthing friendly

Valley Hospital

Acute Care Hospitals · Paramus, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310012

Location4 Valley Health PlazaParamus, NJ 07652 · Bergen County

Emergency services Birthing friendly

Englewood Hospital And Medical Center

Acute Care Hospitals · Englewood, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310045

Location350 Engle StEnglewood, NJ 07631 · Bergen County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07410 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

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.

ALEXANDER WESTCOTT

Family Medicine