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PAUL R BALASH M.D.
NPI 1073741625
Surgery in Oak Lawn, IL

Active since June 22, 2009PECOS EnrolledAccepts Medicare Assignment
4400 W 95TH ST STE 413, OAK LAWN, IL 60453(708) 346-4055(708) 499-0948 Get Directions Write a Review

NPPES record last updated: December 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 10, 2021, Apr 21, 2020, Mar 28, 2020 (3 updates tracked since 2020).

About Paul R Balash M.d. NPPES

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

PAUL R BALASH M.D. (NPI 1073741625) is an individual surgery provider in Oak Lawn, Illinois, licensed in Illinois (036129228) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Advocate Trinity Hospital, and is a graduate of Rush Medical College Of Rush University (2009).

NPPES Registry Identity

NPI1073741625
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NamePAUL R BALASHCredential: M.D.
Location Address4400 W 95TH ST STE 413Oak Lawn, IL 60453-2662
Mailing Address4400 W 95th St Ste 413Oak Lawn, IL 60453-2662 · (708) 346-4055
Phone(708) 346-4055
Fax(708) 499-0948
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 2009
Enumeration DateJune 22, 2009
Last NPPES UpdateDecember 10, 20213 updates tracked since enumeration
NPPES CertifiedDecember 10, 2021
✔ NPI 1073741625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in IL · 036129228
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
4400 W 95TH ST STE 413, Oak Lawn, IL 60453
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Paul R Balash 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 ID4981916970
PECOS Enrollment IDI20150713001444
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.

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.
115 services56 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.
88 services84 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.
72 services72 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.
66 services50 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
23 services23 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
22 services22 patients

Hospital Affiliations CMS Care Compare 2

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

Advocate Trinity Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140048
Location2320 E 93rd StChicago, IL 60617 · Cook County
Emergency services Birthing friendly

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60453 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
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.

Other Providers at the Same Location NPPES 4

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

JASON ZIMMERMANN M.D.
Surgery
4400 W 95TH ST STE 413
OAK LAWN, IL 60453
Cook County (708) 499-0034
MIDWEST SURGICAL GROUP SC
Surgery
4400 W 95TH ST STE 413
OAK LAWN, FL 60453
Cook County (708) 346-4055
MALLORY PAULETTE KOSOW
Physician Assistant
4400 W 95TH ST STE 413
OAK LAWN, IL 60453
Cook County (708) 346-4055
DR. AMEER GOMBERAWALLA M.D.
Surgery
4400 W 95TH ST STE 413
OAK LAWN, IL 60453
Cook County (708) 346-4055

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 Paul Balash's NPI number?

The NPI number for Paul Balash is 1073741625. It was assigned to this individual provider in the NPPES registry on June 22, 2009.

Where is Paul Balash located?

Paul Balash practices at 4400 W 95th St Ste 413, Oak Lawn, IL 60453. The listed phone number is (708) 346-4055.

What is Paul Balash's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Paul Balash enrolled in Medicare?

Yes. Paul Balash 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.

What insurance does Paul Balash accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Paul Balash 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 Paul Balash affiliated with any hospitals?

According to CMS data, Paul Balash is affiliated with Advocate Trinity Hospital and Advocate Christ Hospital & Medical Center.

When was this NPI record last updated?

The NPPES record for Paul Balash was last updated on December 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.