DESTINY SHANTEE BALLANCE FNP-BC
NPI 1073334959
Nurse Practitioner in Rancho Cucamonga, CA
About Destiny Shantee Ballance Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DESTINY SHANTEE BALLANCE FNP-BC (NPI 1073334959) is an individual nurse practitioner in Rancho Cucamonga, California, licensed in California (95038680) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2026).
NPPES Registry Identity
Specialties & Licenses 2
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
Destiny Shantee Ballance Fnp-bc 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.
Medicare Billing Reassignment
Medicare enrollment records show Destiny Ballance reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Bernardino, CA 92404
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: St. John's Community Health
- 404 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91730 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
RANCHO CUCAMONGA, CA 91730
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 Destiny Ballance's NPI number?
The NPI number for Destiny Ballance is 1073334959. It was assigned to this individual provider in the NPPES registry on October 23, 2024.
Where is Destiny Ballance located?
Destiny Ballance practices at 11175 Azusa Ct Ste 110, Rancho Cucamonga, CA 91730. The listed phone number is (909) 715-9611.
What is Destiny Ballance's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Destiny Ballance enrolled in Medicare?
Yes. Destiny Ballance 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 organization bills Medicare for Destiny Ballance's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Destiny Ballance reassigns Medicare benefits to St. Johns Community Health (San Bernardino, CA). The 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 Destiny Ballance's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Destiny Ballance was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days 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.
# Destiny Shantee Ballance, FNP-BC · NPI 1073334959
Nurse Practitioner physician in Rancho Cucamonga, California. Individual provider, active in the CMS NPPES registry since October 23, 2024.
## Identity
- **NPI:** 1073334959 (Entity type: Individual)
- **Enumerated:** October 23, 2024
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 95038680 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 11175 AZUSA CT STE 110, Rancho Cucamonga, CA 91730-4933
- **Phone:** (909) 715-9611
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St. Johns Community Health (NPI 1780376947, San Bernardino, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2026
## Record status
- **NPPES last updated:** September 2, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1073334959) · Data from the CMS NPPES public registry.