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DR. GAYLE PHADUNGCHAI BALBA M.D.
NPI 1073570354
Internal Medicine - Infectious Disease in Washington, DC

Active since April 28, 2006PECOS EnrolledAccepts Medicare Assignment
76.55/100
CMS Quality Rating
3800 RESERVOIR RD NW, KOBER-COGAN BLD SUITE110, WASHINGTON, DC 20007(202) 687-6845(202) 687-6476 Get Directions Write a Review

NPPES record last updated: June 26, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Gayle Phadungchai Balba M.d. NPPES

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

DR. GAYLE PHADUNGCHAI BALBA M.D. (NPI 1073570354) is an individual infectious disease provider in Washington, District Of Columbia, licensed in District Of Columbia (MD31818) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS and is a graduate of Georgetown University School Of Medicine (1998).

NPPES Registry Identity

NPI1073570354
Entity TypeIndividualFemale
Primary Taxonomy207RI0200X
Provider Legal NameDR. GAYLE PHADUNGCHAI BALBACredential: M.D.
Location Address3800 RESERVOIR RD NW, KOBER-COGAN BLD SUITE110Washington, DC 20007-2113
Mailing Address3800 Reservoir Rd Nw, Kober-cogan Bld Suite110Washington, DC 20007-2113 · (202) 687-6845 · Fax (202) 687-6476
Phone(202) 687-6845
Fax(202) 687-6476
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 1998
Enumeration DateApril 28, 2006
Last NPPES UpdateJune 26, 2009
✔ NPI 1073570354 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 DC · MD31818
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.
3800 RESERVOIR RD NW, Washington, DC 20007
Open in Google Maps ↗

Other Identifiers 3

OtherP00706930DC · Railroad Medicare
Medicare UPINH85279
Medicare PIN003300M65DC

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. Gayle Phadungchai Balba 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 ID3274538103
PECOS Enrollment IDI20080325000457
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 4

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.
232 services87 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.
149 services92 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.
56 services53 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.
34 services32 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20007 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

76.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.16
Promoting Interoperability100
Improvement Activities40
Cost55.94

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. KAUSTUBH SUBHASH YADWADKAR M.D.
Radiology (Diagnostic Radiology)
3800 RESERVOIR RD NW, CG201
WASHINGTON, DC 20007
District of Columbia (304) 206-7595
FRED MO MD
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-8766
SEBLE YIRGA
Nurse Practitioner (Family)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-7265
ARLETTE THOMPSON-PILE
Physical Therapy Assistant
3800 RESERVOIR RD NW, PHYSICAL MEDICINE AND REHBAILITATION DEPARTMENT
WASHINGTON, DC 20007
District of Columbia (202) 444-3689
JENNA ELIZABETH HOROWITZ
Physician Assistant (Surgical)
3800 RESERVOIR RD NW, NEUROSURGERY DEPARTMENT
WASHINGTON, DC 20007
District of Columbia (202) 444-2000
HALEY SWANSON FOSTER M.D.
Radiology (Vascular & Interventional Radiology)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-5022
SOPHIA RIZVI MD
Radiology (Radiation Oncology)
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-2000
CLAIRE DALBY MD
Student in an Organized Health Care Education/Training Program
3800 RESERVOIR RD NW
WASHINGTON, DC 20007
District of Columbia (202) 444-7106

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 Gayle Balba's NPI number?

The NPI number for Gayle Balba is 1073570354. It was assigned to this individual provider in the NPPES registry on April 28, 2006.

Where is Gayle Balba located?

Gayle Balba practices at 3800 Reservoir Rd NW Kober-Cogan Bld Suite110, Washington, DC 20007. The listed phone number is (202) 687-6845.

What is Gayle Balba's specialty?

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

Is Gayle Balba enrolled in Medicare?

Yes. Gayle Balba 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.

When was this NPI record last updated?

The NPPES record for Gayle Balba was last updated on June 26, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.