ANTHONY J BALSAMO MD
NPI 1104812239
Orthopaedic Surgery in Wilkes Barre, PA

Active since September 23, 2005PECOS EnrolledAccepts Medicare Assignment
1175 E MOUNTAIN BLVD, WILKES BARRE, PA 18702(570) 808-1093(570) 808-7878 Get Directions Write a Review

NPPES record last updated: August 12, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Anthony J Balsamo Md NPPES

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

ANTHONY J BALSAMO MD (NPI 1104812239) is an individual orthopaedic surgery provider in Wilkes Barre, Pennsylvania, licensed in Pennsylvania (MD036494L) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Geisinger Wyoming Valley Medical Center, and is a graduate of Medical College Of Pennsylvania (1974).

NPPES Registry Identity

NPI1104812239
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameANTHONY J BALSAMOCredential: MD
Location Address1175 E MOUNTAIN BLVDWilkes Barre, PA 18702-7906
Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 271-6144 · Fax (570) 271-6578
Fax(570) 808-7878
Sole ProprietorNo
Medical School CMSMedical College Of PennsylvaniaGraduated 1974
Enumeration DateSeptember 23, 2005
Last NPPES UpdateAugust 12, 2020
NPPES CertifiedAugust 12, 2020
NPI 1104812239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in PA · MD036494L
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.
1175 E MOUNTAIN BLVD, Wilkes Barre, PA 18702

Accepted 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

Anthony J Balsamo 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 ID1850366519
PECOS Enrollment IDI20040827000173
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.

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.
76 services60 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.
28 services26 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
16 services13 patients
Treatment of broken neck of thigh bone with bone implant 27245
This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390270
Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18702 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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 20

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

Physician Assistant
1175 E MOUNTAIN BLVD
WILKES BARRE, PA 18702
Physician Assistant
1175 E MOUNTAIN BLVD
WILKES BARRE, PA 18702
Specialist/Technologist (Athletic Trainer)
1175 E MOUNTAIN BLVD
WILKES BARRE, PA 18702
Physician Assistant
1175 E MOUNTAIN BLVD
WILKES BARRE, PA 18702
Physician Assistant
1175 E MOUNTAIN BLVD
WILKES BARRE, PA 18702
Physician Assistant
1175 E MOUNTAIN BLVD
WILKES BARRE, PA 18702
Orthopaedic Surgery
1175 E MOUNTAIN BLVD, DEPARTMENT OF ORTHOPAEDICS
WILKES BARRE, PA 18702
Physical Therapy Assistant
1175 E MOUNTAIN BLVD
WILKES-BARRE, PA 18702

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 Anthony Balsamo's NPI number?

The NPI number for Anthony Balsamo is 1104812239. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Anthony Balsamo located?

Anthony Balsamo practices at 1175 E Mountain Blvd, Wilkes Barre, PA 18702. The listed phone number is (570) 808-1093.

What is Anthony Balsamo's specialty?

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

Is Anthony Balsamo enrolled in Medicare?

Yes. Anthony Balsamo 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 Anthony Balsamo accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Anthony Balsamo 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 Anthony Balsamo affiliated with any hospitals?

According to CMS data, Anthony Balsamo is affiliated with Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Anthony Balsamo was last updated on August 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.