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DR. PETER W. BALKIN M.D.
NPI 1104921725
Radiology - Diagnostic Radiology in Honolulu, HI

Active since September 14, 2006PECOS EnrolledAccepts Medicare Assignment
82.79/100
CMS Quality Rating
888 S KING ST, HONOLULU, HI 96813(808) 522-4000(808) 522-4240 Get Directions Write a Review

NPPES record last updated: March 19, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Peter W. Balkin M.d. NPPES

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

DR. PETER W. BALKIN M.D. (NPI 1104921725) is an individual diagnostic radiology provider in Honolulu, Hawaii, licensed in Hawaii (MD-6428) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Marshfield Medical Center - Rice Lake, and is a graduate of Vanderbilt University School Of Medicine (1981).

NPPES Registry Identity

NPI1104921725
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. PETER W. BALKINCredential: M.D.
Location Address888 S KING STHonolulu, HI 96813-3009
Mailing Address888 S King St, Straub Department Of RadiologyHonolulu, HI 96813-3097 · (808) 522-4000 · Fax (808) 522-4240
Phone(808) 522-4000
Fax(808) 522-4240
Sole ProprietorNo
Medical School CMSVanderbilt University School Of MedicineGraduated 1981
Enumeration DateSeptember 14, 2006
Last NPPES UpdateMarch 19, 2012
✔ NPI 1104921725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in HI · MD-6428
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
888 S KING ST, Honolulu, HI 96813
Open in Google Maps ↗

Other Identifiers 5

Other0000064501HI · Hmsa
Medicare ID-Type Unspecified53816HI
Medicaid05607701HI
Medicare UPINB62456HI
Other7940444HI · Uha

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Peter W. Balkin 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 ID8022913581
PECOS Enrollment IDI20080207000537
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Peter Balkin reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Marshfield Clinic Inc
4,118 mi
Clinic/Center
1000 N OAK AVE
Marshfield, WI 54449
  • Reassigned Medicare billing, Hawaii enrollment
  • 2 clinicians in this Medicare group
NPI 1952347981 (715) 387-5511
Mchs Hospitals Inc
4,118 mi
Clinic/Center
1000 N OAK AVE
Marshfield, WI 54449
  • Reassigned Medicare billing, Hawaii enrollment
  • 2 clinicians in this Medicare group
NPI 1093221434 (715) 387-5511

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

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.

Ct scan head or brain without contrast 70450
A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
59 services59 patients
X-ray of lower and sacral spine, 2-3 views 72100
An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
43 services43 patients
Ct scan of upper spine without contrast 72125
A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.
18 services18 patients
X-ray of upper spine, 2-3 views 72040
An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.
13 services13 patients
X-ray of lower and sacral spine, minimum of 4 views 72110
An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.
11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Marshfield Medical Center - Rice Lake

Acute Care Hospitals · Rice Lake, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520011
Location1700 West Stout StreetRice Lake, WI 54868 · Barron County
Emergency services Birthing friendly

Marshfield Medical Center

Acute Care Hospitals · Marshfield, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520037
Location611 St Joseph AveMarshfield, WI 54449 · Wood County
Emergency services Birthing friendly

Marshfield Medical Center - Weston

Acute Care Hospitals · Weston, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520202
Location3400 Ministry ParkwayWeston, WI 54476 · Marathon County
Emergency services Birthing friendly

Marshfield Medical Center - Eau Claire

Acute Care Hospitals · Eau Claire, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520210
Location2310 Craig RdEau Claire, WI 54701 · Eau Claire County
Emergency services Birthing friendly

Marshfield Medical Center - Minocqua

Acute Care Hospitals · Minocqua, WI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520212
Location9576 Highway 70Minocqua, WI 54548 · Oneida County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96813 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
$92.50 typical visit price
range $60.53 – $180.05
Typical copayment $23.12 (range $15.13 – $45.01)
Most-billed visit code 99203
Established Patient
$74.92 typical visit price
range $20.09 – $147.56
Typical copayment $18.73 (range $5.02 – $36.89)
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.

82.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.98
Promoting Interoperability99
Improvement Activities40
Cost66.19

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. SYLVIA Y. TERADA NP
Nurse Practitioner
888 S KING ST, DERMATOLOGY DEPARTMENT
HONOLULU, HI 96813
Honolulu County (808) 522-4360
DR. JOSEPH R. VIERRA M.D.
Internal Medicine (Critical Care Medicine)
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-4000
DR. BEAU K. NAKAMOTO M.D.
Psychiatry & Neurology (Neurology)
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-4000
DR. JAY L. GREKIN M.D.
Dermatology
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-4360
DR. TIMOTHY CHRISTOPHER LAEGER M.D.
Emergency Medicine
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-3714
SCOTT T YOKOTA
Physical Therapist
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-3496
JESSICA GREEN
Surgery (Vascular Surgery)
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-4469
TAMMY YAGUCHI MPT
Physical Therapist
888 S KING ST
HONOLULU, HI 96813
Honolulu County (808) 522-4602

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 Peter Balkin's NPI number?

The NPI number for Peter Balkin is 1104921725. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Where is Peter Balkin located?

Peter Balkin practices at 888 S King St, Honolulu, HI 96813. The listed phone number is (808) 522-4000.

What is Peter Balkin's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Peter Balkin enrolled in Medicare?

Yes. Peter Balkin 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.

Which organizations bill Medicare for Peter Balkin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Balkin reassigns Medicare benefits to 2 organizations: Marshfield Clinic Inc (Marshfield, WI) and Mchs Hospitals Inc (Marshfield, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Peter Balkin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Peter Balkin accept?

Health plans from Sanford Health Plan list Peter Balkin 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 Peter Balkin affiliated with any hospitals?

According to CMS data, Peter Balkin is affiliated with Marshfield Medical Center - Rice Lake, Marshfield Medical Center, Marshfield Medical Center - Weston, Marshfield Medical Center - Eau Claire and Marshfield Medical Center - Minocqua.

When was this NPI record last updated?

The NPPES record for Peter Balkin was last updated on March 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.