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DR. GREGORY BALABANIAN M.D.
NPI 1033406277
Internal Medicine - Infectious Disease in Powell, TN

Active since July 08, 2011PECOS EnrolledAccepts Medicare Assignment
97.4/100
CMS Quality Rating
7557B DANNAHER DR STE 225, POWELL, TN 37849(865) 647-2663(865) 647-0025 Get Directions Write a Review

NPPES record last updated: May 14, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 14, 2025, May 9, 2025, Dec 16, 2021 and 1 more (4 updates tracked since 2018).

About Dr. Gregory Balabanian M.d. NPPES

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

DR. GREGORY BALABANIAN M.D. (NPI 1033406277) is an individual infectious disease provider in Powell, Tennessee, licensed in Tennessee (MD73387) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Physicians Regional Medical Center, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1033406277
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. GREGORY BALABANIANCredential: M.D.
Location Address7557B DANNAHER DR STE 225Powell, TN 37849-3568
Mailing Address7557b Dannaher Dr Ste 225Powell, TN 37849-3568 · (865) 647-2663 · Fax (865) 647-0025
Phone(865) 647-2663
Fax(865) 647-0025
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 8, 2011
Last NPPES UpdateMay 14, 20254 updates tracked since enumeration
NPPES CertifiedMay 14, 2025
✔ NPI 1033406277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in TN · MD73387
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
7557B DANNAHER DR STE 225, Powell, TN 37849
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.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. Gregory Balabanian 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 ID6608139381
PECOS Enrollment IDI20250520005085
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 Reassignments

3

Medicare enrollment records show Gregory Balabanian reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Knoxville Hma Physician Management, LLC
6.6 mi
Pulmonary Disease
4711 CENTERLINE DR STE 100
Knoxville, TN 37917
  • Reassigned Medicare billing, Tennessee enrollment
  • 147 clinicians in this Medicare group
NPI 1629356969 (865) 647-3260
Appalachian Regional Healthcare, Inc.
41 mi
Emergency Medicine
3600 CUMBERLAND AVE
Middlesboro, KY 40965
  • Reassigned Medicare billing, Kentucky enrollment
  • 419 clinicians in this Medicare group
NPI 1134204688 (606) 242-1100
Arh Tug Valley Health Services, Inc.
128 mi
Multi-Specialty
787 PARKWAY DR
Salyersville, KY 41465
  • Reassigned Medicare billing, Kentucky enrollment
  • 242 clinicians in this Medicare group
NPI 1942962105 (606) 349-3511

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 5

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.
782 services115 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.
724 services156 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.
172 services143 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
37 services16 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.
23 services22 patients

Hospital Affiliations CMS Care Compare

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

Physicians Regional Medical Center

Acute Care Hospitals · Powell, TN
2/5 CMS rating
OwnershipProprietary
CMS Certification Number440120
Location7565 Dannaher Way PowellPowell, TN 37849 · Knox County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37849 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

97.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.55
Promoting Interoperability100
Improvement Activities40

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.

MIRANDA PRICHARD
Nurse Practitioner (Family)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-3450
MRS. LESLIE P STONE RN, MSN, RNC
Clinical Nurse Specialist (Women's Health)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-3450
YASIR NAEEM AKHTAR M.D.
Internal Medicine (Interventional Cardiology)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-5979
DR. PURUSHOTHAMAN MUTHUSAMY MD
Internal Medicine (Interventional Cardiology)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-5800
DR. KYLE MCCOY M.D.
Internal Medicine (Cardiovascular Disease)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-5800
DR. CHIMEZIE UCHENNA MBACHI MD
Internal Medicine (Gastroenterology)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 859-7330
DR. MITESHKUMAR BHUPENDRASINH SOLANKI MD
Internal Medicine (Interventional Cardiology)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-5800
RASHMI UJANEPPA HOTTIGOUDAR MD
Internal Medicine (Clinical Cardiac Electrophysiology)
7557B DANNAHER DR STE 225
POWELL, TN 37849
Knox County (865) 647-5800

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 Gregory Balabanian's NPI number?

The NPI number for Gregory Balabanian is 1033406277. It was assigned to this individual provider in the NPPES registry on July 8, 2011.

Where is Gregory Balabanian located?

Gregory Balabanian practices at 7557B Dannaher Dr Ste 225, Powell, TN 37849. The listed phone number is (865) 647-2663.

What is Gregory Balabanian's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Gregory Balabanian enrolled in Medicare?

Yes. Gregory Balabanian 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.

Which organizations bill Medicare for Gregory Balabanian's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Balabanian reassigns Medicare benefits to 3 organizations: Knoxville Hma Physician Management, LLC (Knoxville, TN), Appalachian Regional Healthcare, Inc. (Middlesboro, KY) and Arh Tug Valley Health Services, Inc. (Salyersville, KY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gregory Balabanian's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gregory Balabanian accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 4 other insurers list Gregory Balabanian as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Gregory Balabanian affiliated with any hospitals?

According to CMS data, Gregory Balabanian is affiliated with Physicians Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Gregory Balabanian was last updated on May 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.