DR. THOMAS C. BALSHI M.D.
NPI 1063400646
Dermatology - Procedural Dermatology in Delray Beach, FL

Active since October 08, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 10D2014966 · Certificate of Compliance
76.59/100
CMS Quality Rating
4665 W ATLANTIC AVE, DELRAY BEACH, FL 33445(561) 272-6000 Get Directions Write a Review

NPPES record last updated: November 12, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Thomas C. Balshi M.d. NPPES

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

DR. THOMAS C. BALSHI M.D. (NPI 1063400646) is an individual procedural dermatology provider in Delray Beach, Florida, licensed in Florida (ME 88514) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, holds a CLIA Certificate of Compliance certificate valid through November 30, 2026, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1063400646
Entity TypeIndividualMale
Primary Taxonomy207NS0135X
Provider Legal NameDR. THOMAS C. BALSHICredential: M.D.
Location Address4665 W ATLANTIC AVEDelray Beach, FL 33445-3800
Mailing Address4665 W Atlantic AveDelray Beach, FL 33445-3800 · (561) 272-6000
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateOctober 8, 2005
Last NPPES UpdateNovember 12, 2014
NPI 1063400646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License Licensed in FL · ME 88514
Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

4665 W ATLANTIC AVE, Delray Beach, FL 33445

Other Identifiers 2

Medicare ID-Type Unspecified82044ZFL
Medicare UPINH69053FL

Accepted 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. Thomas C. Balshi 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 ID3779474622
PECOS Enrollment IDI20040628001669
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2014966

Thomas C Balshi MD PA · Delray Beach, FL
Active · expires Nov 30, 2026
CLIA Number10D2014966
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorDr. Thomas C. Balshi
Laboratory Phone(561) 272-6000
Laboratory LocationThomas C Balshi MD PA4665 W Atlantic Ave, Delray Beach, FL 33445
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Areas of Expertise CMS Part B claims 35

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.

Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg J7345
Aminolevulinic acid hcl is a topical gel used to treat certain skin conditions. It works by making affected skin cells more sensitive to light, which is then used to destroy these cells. The gel is applied by a healthcare professional.
4,800 services16 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.
759 services401 patients
Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
360 services92 patients
Destruction of precancer skin growth, 15 or more growths 17004
This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.
352 services224 patients
Shaving of skin growth of body, arms, or legs, more than 2.0 cm 11303
This procedure involves the removal of a skin growth on your body, arms, or legs that is over 2.0 cm. A special tool is used to shave off the growth, often under local anesthesia. It's a routine, safe process to maintain skin health.
250 services197 patients
Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm 11302
This procedure involves the careful removal of a skin growth on your body, arms, or legs. The growth is between 1.1 and 2.0 cm. A special tool is used to shave off the growth, which is a quick and relatively painless process.
207 services169 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33445 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
$91.69 typical visit price
range $58.56 – $179.05
Typical copayment $22.92 (range $14.64 – $44.76)
Most-billed visit code 99203
Established Patient
$73.00 typical visit price
range $18.44 – $144.68
Typical copayment $18.25 (range $4.61 – $36.17)
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.

76.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality53.19
Improvement Activities40

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
0%577 patients1/55-star benchmark: 95%
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.
72%1,533 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.
88%1,833 patients4/55-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.
94%2,232 patients4/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
0%744 patients1/55-star benchmark: 90%
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…
29%1,180 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…
68%2,232 patients3/55-star benchmark: 100%
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.

Other Providers at the Same Location NPPES 6

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

Hearing Aid Equipment
4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445
Dentist (General Practice)
4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445
Dentist (General Practice)
4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445
Hearing Aid Equipment
4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445
Anesthesiology
4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445
Dermatology (Procedural Dermatology)
4665 W ATLANTIC AVE
DELRAY BEACH, FL 33445

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 Thomas Balshi's NPI number?

The NPI number for Thomas Balshi is 1063400646. It was assigned to this individual provider in the NPPES registry on October 8, 2005.

Where is Thomas Balshi located?

Thomas Balshi practices at 4665 W Atlantic Ave, Delray Beach, FL 33445. The listed phone number is (561) 272-6000.

What is Thomas Balshi's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Thomas Balshi enrolled in Medicare?

Yes. Thomas Balshi 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.

Does Thomas Balshi hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D2014966) is associated with this NPI, valid through November 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Thomas Balshi accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Oscar Health Maintenance Organization of Florida list Thomas Balshi 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.

When was this NPI record last updated?

The NPPES record for Thomas Balshi was last updated on November 12, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.