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SANDRA K BALMORIA MD
NPI 1023379153
Family Medicine in New Church, VA

Active since June 05, 2012PECOS EnrolledAccepts Medicare Assignment
81.88/100
CMS Quality Rating
5219 LANKFORD HIGHWAY, NEW CHURCH, VA 23415(757) 414-0400 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sandra K Balmoria Md NPPES

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

SANDRA K BALMORIA MD (NPI 1023379153) is an individual family medicine provider in New Church, Virginia, licensed in Virginia (0116024489) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with Community Memorial Hospital, and maintains a secondary practice location in South Hill.

NPPES Registry Identity

NPI1023379153
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSANDRA K BALMORIACredential: MD
Location Address5219 LANKFORD HIGHWAYNew Church, VA 23415-1715
Mailing Address20280 Market StreetOnancock, VA 23417 · (757) 414-0400
Phone(757) 414-0400
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 5, 2012
Last NPPES UpdateMay 22, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1023379153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in VA · 0116024489✔ Licensed in VA · 0101254483
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5219 LANKFORD HIGHWAY, New Church, VA 23415
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Other Names 1

Former Name (1)Sandra Burrer

Secondary Practice Location 1

Location 11755 N Mecklenburg AveSouth Hill, VA 23970-4080 · Phone (434) 584-2273 · Fax (434) 774-2401

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

Sandra K Balmoria 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 ID1658515200
PECOS Enrollment IDI20150819006762
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 10

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.
229 services124 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.
84 services41 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.
44 services42 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.
35 services35 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.
27 services25 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.
24 services21 patients

Hospital Affiliations CMS Care Compare

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

Community Memorial Hospital

Acute Care Hospitals · South Hill, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490098
Location1755 North Mecklenburg AvenueSouth Hill, VA 23970 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23415 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

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.

81.88/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.91
Promoting Interoperability100
Improvement Activities40
Cost64.69

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 Sandra Balmoria's NPI number?

The NPI number for Sandra Balmoria is 1023379153. It was assigned to this individual provider in the NPPES registry on June 5, 2012. The provider is also known as Sandra Burrer.

Where is Sandra Balmoria located?

Sandra Balmoria practices at 5219 Lankford Highway, New Church, VA 23415. The listed phone number is (757) 414-0400.

What is Sandra Balmoria's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sandra Balmoria enrolled in Medicare?

Yes. Sandra Balmoria 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 Sandra Balmoria affiliated with any hospitals?

According to CMS data, Sandra Balmoria is affiliated with Community Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Sandra Balmoria was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.