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SOPHIA REBECCA BALDERMAN MD
NPI 1104098607
Internal Medicine - Hematology in Cleveland, OH

Active since March 25, 2008PECOS EnrolledAccepts Medicare Assignment
9500 EUCLID AVE, CLEVELAND, OH 44195(716) 845-2300(716) 845-1759 Get Directions Write a Review

NPPES record last updated: January 17, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 17, 2022, Dec 30, 2021, Oct 9, 2019 and 1 more (4 updates tracked since 2019).

About Sophia Rebecca Balderman Md NPPES

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

SOPHIA REBECCA BALDERMAN MD (NPI 1104098607) is an individual hematology provider in Cleveland, Ohio, licensed in New York (254222) and active in the NPI registry since March 2008. She is enrolled in Medicare PECOS, is affiliated with Akron General Medical Center, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1104098607
Entity TypeIndividualFemale
Primary Taxonomy207RH0000X
Provider Legal NameSOPHIA REBECCA BALDERMANCredential: MD
Location Address9500 EUCLID AVECleveland, OH 44195-0001
Mailing Address9500 Euclid AveCleveland, OH 44195-0001 · (216) 444-7923 · Fax (216) 444-5679
Phone(716) 845-2300
Fax(716) 845-1759
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateMarch 25, 2008
Last NPPES UpdateJanuary 17, 20224 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2022
✔ NPI 1104098607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0000X
License✔ Licensed in NY · 254222
Definition
An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.
Also ListedInternal MedicineTaxonomy 207R00000X · License 254222 (NY)
9500 EUCLID AVE, Cleveland, OH 44195
Open in Google Maps ↗

Other Identifiers 1

Medicaid03616828NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Insurance Corporation of Ohio.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

Sophia Rebecca Balderman Md 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 ID9335381656
PECOS Enrollment IDI20211208001732
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 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.
155 services36 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.
69 services31 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.
38 services16 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
19 services19 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.
19 services13 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.
18 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Akron General Medical Center

Acute Care Hospitals · Akron, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360027
Location1 Akron General AvenueAkron, OH 44307 · Summit County
Emergency services Birthing friendly

Mercy Medical Center

Acute Care Hospitals · Canton, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360070
Location1320 Mercy Drive NWCanton, OH 44708 · Stark County
Emergency services Birthing friendly

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

Cleveland Clinic Avon Hospital

Acute Care Hospitals · Avon, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360364
Location33300 Cleveland Clinic BlvdAvon, OH 44011 · Lorain County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44195 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
$166.65 typical visit price
range $54.34 – $166.65
Typical copayment $41.66 (range $13.58 – $41.66)
Most-billed visit code 99205
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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.

MS. MARY COLLEEN RATH R.D., L.D., CNSC
Dietitian, Registered
9500 EUCLID AVE, M17
CLEVELAND, OH 44195
Cuyahoga County (216) 444-6986
DR. CHRISTOPHER F TENGGARDJAJA M.D.
Urology (Urogynecology and Reconstructive Pelvic Surgery)
9500 EUCLID AVE, Q10-1
CLEVELAND, OH 44195
Cuyahoga County (216) 444-5600
DR. MASATO FUJIKI M.D., PH.D.
Surgery
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (216) 444-8007
KRISTIN R JOHNSON CNP
Nurse Practitioner
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (800) 223-2273
MONICA LYNN SHEIN CRNA
Nurse Anesthetist, Certified Registered
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (800) 223-2273
MRS. TONYA RENEE GOINGS ACNP-BC
Nurse Practitioner (Acute Care)
9500 EUCLID AVE, SUITE RC25
CLEVELAND, OH 44195
Cuyahoga County (216) 444-2200
MS. DANA ANNE RUBIS CNP
Nurse Practitioner (Critical Care Medicine)
9500 EUCLID AVE, G58
CLEVELAND, OH 44195
Cuyahoga County (216) 444-5086
DR. RACHAEL C SULLIVAN M.D.
Surgery
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (440) 449-1101

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 Sophia Balderman's NPI number?

The NPI number for Sophia Balderman is 1104098607. It was assigned to this individual provider in the NPPES registry on March 25, 2008.

Where is Sophia Balderman located?

Sophia Balderman practices at 9500 Euclid Ave, Cleveland, OH 44195. The listed phone number is (716) 845-2300.

What is Sophia Balderman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Is Sophia Balderman enrolled in Medicare?

Yes. Sophia Balderman 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 Sophia Balderman accept?

Health plans from CareSource and Oscar Insurance Corporation of Ohio list Sophia Balderman 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 Sophia Balderman affiliated with any hospitals?

According to CMS data, Sophia Balderman is affiliated with Akron General Medical Center, Mercy Medical Center, Cleveland Clinic and Cleveland Clinic Avon Hospital.

When was this NPI record last updated?

The NPPES record for Sophia Balderman was last updated on January 17, 2022. 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.