PELBRETON COLLYMORE BALFOUR JR. MD
NPI 1063633576
Internal Medicine - Cardiovascular Disease in Danville, PA

Q: What is Pelbreton Balfour's NPI number?

The NPI number for Pelbreton Balfour is 1063633576. It was assigned to this individual provider in the NPPES registry on May 1, 2007.

Q: What is Pelbreton Balfour's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Pelbreton Balfour was last updated on June 8, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 01, 2007PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

100 N ACADEMY AVE, DANVILLE, PA 17822(570) 271-6523(570) 271-8056 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 14, 2026, Feb 2, 2026, Nov 21, 2023 and 5 more (8 updates tracked since 2017).

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About Pelbreton Collymore Balfour Jr. Md NPPES

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

PELBRETON COLLYMORE BALFOUR JR. MD (NPI 1063633576) is an individual cardiovascular disease provider in Danville, Pennsylvania, licensed in Pennsylvania (MD494495) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Baptist Hospital, and is a graduate of University Of Pittsburgh School Of Medicine (2006).

NPPES Registry Identity

NPI1063633576

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NamePELBRETON COLLYMORE BALFOUR JR.Credential: MD

Location Address100 N ACADEMY AVEDanville, PA 17822-9800

Mailing Address100 N Academy AveDanville, PA 17822-9800 · (570) 271-6523 · Fax (570) 271-8056

Phone(570) 271-6523

Fax(570) 271-8056

Sole ProprietorNo

Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 2006

Enumeration DateMay 1, 2007

Last NPPES UpdateJune 8, 20268 updates tracked since enumeration

NPPES CertifiedJune 8, 2026

✔ NPI 1063633576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in PA · MD494495

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

100 N ACADEMY AVE, Danville, PA 17822

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Other Identifiers 4

Medicaid020721600FL

Medicaid209108AL

OtherME131374FL · Florida Medical License

OtherMD.36331AL · Alabama Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Blue Cross and Blue Shield of Alabama and more.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

Pelbreton Collymore Balfour Jr. 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 ID8325183528

PECOS Enrollment IDI20150323001680, I20180712000878, I20250908001073, I20260218001374, I20260222000177, I20260326002176, I20260501001949

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 26

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.

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

617 services609 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

491 services445 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.

169 services151 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

151 services149 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

139 services138 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

121 services121 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

119 services112 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

112 services111 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

104 services103 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.

87 services67 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.

69 services68 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

64 services61 patients

Mri scan of heart before and after contrast 75561

An MRI scan of the heart with contrast is a non-invasive imaging test. It uses magnetic fields and radio waves to create detailed pictures of your heart. The contrast dye improves the clarity of these images. This test helps in diagnosing heart conditions.

54 services54 patients

Ultrasound of heart with continuous electrocardiogram (ecg) during rest, exercise and/or drug induced stress with review and report 93351

This procedure involves using ultrasound technology to create images of your heart while you rest, exercise, or undergo drug-induced stress. An ECG continuously monitors your heart's electrical activity. It helps doctors assess heart health and function.

44 services44 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

43 services43 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

41 services39 patients

Ultrasound of heart blood flow, valves and chambers 93320

An ultrasound of your heart, also known as an echocardiogram, is a test that uses sound waves to create detailed images of your heart. It helps doctors check the health of your heart's chambers, valves, and blood flow.

36 services36 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.

36 services35 patients

Heart muscle strain imaging 93356

Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.

35 services35 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.

32 services32 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

30 services30 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

29 services29 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

22 services22 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

19 services19 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

14 services14 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Hospital

Acute Care Hospitals · Pensacola, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100093

Location123 Baptist WayPensacola, FL 32503 · Escambia County

Emergency services Birthing friendly

Phoebe Putney Memorial Hospital

Acute Care Hospitals · Albany, GA

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110007

Location417 Third AvenueAlbany, GA 31703 · Dougherty County

Emergency services Birthing friendly

Phoebe Sumter Medical Center

Acute Care Hospitals · Americus, GA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110044

Location126 Highway 280 WAmericus, GA 31719 · Sumter County

Emergency services Birthing friendly

Chesapeake General Hospital

Acute Care Hospitals · Chesapeake, VA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number490120

Location736 Battlefield Blvd, NorthChesapeake, VA 23320 · Chesapeake City County

Emergency services Birthing friendly

Olympic Medical Center

Acute Care Hospitals · Port Angeles, WA

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number500072

Location939 Caroline StPort Angeles, WA 98362 · Clallam County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17822 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

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.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Referred Medical Equipment & Supplies CMS DME claims 3

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

1 supplier17 claims17 services$18.28 avg. paid by Medicare

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222

DME-Medical/Surgical Supplies · category DA000N

1 supplier17 claims118 services$35.15 avg. paid by Medicare

Injection, milrinone lactate, 5 mg J2260

Treatment-Injections and Infusions (nononcologic) · category RI026N

1 supplier17 claims929 services$1.38 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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.

DR. TARA JEAN LOUX MD

Surgery (Pediatric Surgery)