DR. PAUL MATTHEW BALTHROP M.D.
NPI 1104044700
Orthopaedic Surgery in Savannah, GA

Q: What is Paul Balthrop's NPI number?

The NPI number for Paul Balthrop is 1104044700. It was assigned to this individual provider in the NPPES registry on April 22, 2007.

Q: What is Paul Balthrop's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Paul Balthrop was last updated on August 10, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 22, 2007PECOS EnrolledAccepts Medicare Assignment

4750 WATERS AVE STE 202, SAVANNAH, GA 31404(912) 350-7412(912) 350-7297 Get Directions Write a Review

NPPES record last updated: August 10, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Paul Matthew Balthrop M.d. NPPES

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

DR. PAUL MATTHEW BALTHROP M.D. (NPI 1104044700) is an individual orthopaedic surgery provider in Savannah, Georgia, licensed in Georgia (070040) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Memorial University Medical Center, and is a graduate of University Of Louisville School Of Medicine (2007).

NPPES Registry Identity

NPI1104044700

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. PAUL MATTHEW BALTHROPCredential: M.D.

Location Address4750 WATERS AVE STE 202Savannah, GA 31404

Mailing Address4750 Waters Ave Ste 202Savannah, GA 31404-6278 · (912) 350-7412 · Fax (912) 350-7297

Phone(912) 350-7412

Fax(912) 350-7297

Sole ProprietorNo

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2007

Enumeration DateApril 22, 2007

Last NPPES UpdateAugust 10, 2018

✔ NPI 1104044700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in GA · 070040✔ Licensed in FL · ME111853

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

4750 WATERS AVE STE 202, Savannah, GA 31404

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Other Identifiers 4

Medicaid003135073AGA

OtherP01198989GA · Railroad Medicare

MedicaidGA1467SC

Medicaid004947200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Dr. Paul Matthew Balthrop 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 ID5092970392

PECOS Enrollment IDI20130716000239

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 6

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.

53 services34 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

42 services42 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

30 services18 patients

X-ray of pelvis, minimum of 3 views 72190

An X-ray of the pelvis with a minimum of 3 views is a diagnostic procedure that uses radiation to create images of your lower body area. This helps in detecting issues like fractures, arthritis, or other abnormalities. It's quick, non-invasive, and typically painless.

21 services11 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.

21 services20 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.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Memorial University Medical Center

Acute Care Hospitals · Savannah, GA

1/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110036

Location4700 Waters AvenueSavannah, GA 31404 · Chatham County

Emergency services Birthing friendly

Effingham Health System

Critical Access Hospitals · Springfield, GA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number111306

Location459 Ga Highway 119 SouthSpringfield, GA 31329 · Effingham County

Emergency services

Hilton Head Regional Medical Center

Acute Care Hospitals · Hilton Head Island, SC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number420080

Location25 Hospital Center BlvdHilton Head Island, SC 29925 · Beaufort County

Emergency services Birthing friendly

Coastal Carolina Hospital

Acute Care Hospitals · Hardeeville, SC

2/5 CMS rating

OwnershipProprietary

CMS Certification Number420101

Location1000 Medical Center DriveHardeeville, SC 29927 · Jasper County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31404 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$66.89 typical visit price

range $16.68 – $133.24

Typical copayment $16.72 (range $4.17 – $33.31)

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.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

32%76 patients1/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

90%138 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

100%278 patients5/55-star benchmark: 99%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

100%278 patients5/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

4%278 patients1/55-star benchmark: 59%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Neuromuscular stimulator, electronic shock unit E0745

DME-Other DME · category DE000N

1 supplier22 claims22 services$68.22 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers16 claims16 services$20.15 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 20

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

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