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EDUARDO JOSE BALBONA M.D.
NPI 1073506168
Internal Medicine in Jacksonville, FL

Active since August 24, 2005PECOS Enrolled
85.38/100
CMS Quality Rating
2257 OAK ST, JACKSONVILLE, FL 32204(904) 388-9202(904) 388-9191 Get Directions Write a Review

NPPES record last updated: July 20, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eduardo Jose Balbona M.d. NPPES

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

EDUARDO JOSE BALBONA M.D. (NPI 1073506168) is an individual internal medicine provider in Jacksonville, Florida, licensed in Florida (ME61191) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of Medical College Of Georgia School Of Medicine (1990).

NPPES Registry Identity

NPI1073506168
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameEDUARDO JOSE BALBONACredential: M.D.
Location Address2257 OAK STJacksonville, FL 32204
Mailing Address2257 Oak StJacksonville, FL 32204-4601 · (904) 388-9202 · Fax (904) 388-9191
Phone(904) 388-9202
Fax(904) 388-9191
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 1990
Enumeration DateAugust 24, 2005
Last NPPES UpdateJuly 20, 2016
✔ NPI 1073506168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME61191
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2257 OAK ST, Jacksonville, FL 32204
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Other Identifiers 2

Medicare OSCAR/certification26754XFL
Medicare UPING07930

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eduardo Jose Balbona M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6608774781
PECOS Enrollment IDI20100813000171
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 7

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.
1,243 services472 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.
286 services163 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
67 services62 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.
67 services56 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
67 services67 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.
36 services36 patients

Hospital Affiliations CMS Care Compare 5

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

Ascension St Vincent's Riverside

Acute Care Hospitals · Jacksonville, FL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100040
Location1 Shircliff WayJacksonville, FL 32204 · Duval County
Emergency services

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Ed Fraser Memorial Hospital

Acute Care Hospitals · Macclenny, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100134
Location159 N 3rd StMacclenny, FL 32063 · Baker County
Emergency services

Ascension St Vincent's Southside

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100307
Location4201 Belfort RdJacksonville, FL 32216 · Duval County
Emergency services Birthing friendly

Ascension St Vincent's St Johns County

Acute Care Hospitals · St Johns, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100361
Location205 Trinity WaySt Johns, FL 32259 · St. Johns County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32204 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

85.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.65
Promoting Interoperability78
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
20 suppliers62 claims143 services$6.30 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers22 claims22 services$1.10 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers12 claims12 services$62.29 avg. paid by Medicare
Dynamic adjustable knee extension / flexion device, includes soft interface material E1810
DME-Other DME · category DE000N
1 supplier12 claims12 services$65.56 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers582 claims3,033 services$213.77 avg. paid by Medicare
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system K0554
DME-Other DME · category DE017N
1 supplier327 claims327 services$217.29 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

ART OF MEDICINE P A
Internal Medicine
2257 OAK ST
JACKSONVILLE, FL 32204
Duval County (904) 388-9202

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 Eduardo Balbona's NPI number?

The NPI number for Eduardo Balbona is 1073506168. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Eduardo Balbona located?

Eduardo Balbona practices at 2257 Oak St, Jacksonville, FL 32204. The listed phone number is (904) 388-9202.

What is Eduardo Balbona's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Eduardo Balbona enrolled in Medicare?

Yes. Eduardo Balbona is registered in the Medicare PECOS enrollment system.

What insurance does Eduardo Balbona accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Eduardo Balbona 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 Eduardo Balbona affiliated with any hospitals?

According to CMS data, Eduardo Balbona is affiliated with Ascension St Vincent's Riverside, Baptist Health Medical Center - Jacksonville, Ed Fraser Memorial Hospital, Ascension St Vincent's Southside and Ascension St Vincent's St Johns County.

When was this NPI record last updated?

The NPPES record for Eduardo Balbona was last updated on July 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.