TERRY BALAGNA M.D.
NPI 1114022183
Emergency Medicine in Decatur, IL

Active since September 14, 2006PECOS EnrolledAccepts Medicare Assignment
2300 N EDWARD ST, DECATUR, IL 62526(217) 876-3000 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Terry Balagna M.d. NPPES

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

TERRY BALAGNA M.D. (NPI 1114022183) is an individual emergency medicine provider in Decatur, Illinois and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Decatur Memorial Hospital, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1114022183
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameTERRY BALAGNACredential: M.D.
Location Address2300 N EDWARD STDecatur, IL 62526-4163
Mailing AddressPo Box 587Decatur, IL 62525-0587 · (800) 815-3365 · Fax (631) 321-4235
Sole ProprietorNo
Medical School CMSOtherGraduated 1984
Enumeration DateSeptember 14, 2006
Last NPPES UpdateJuly 9, 2007
NPI 1114022183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
2300 N EDWARD ST, Decatur, IL 62526

Other Identifiers 6

Medicare PIN615740IL
Medicaid036073894-2IL
Other273601IL · Health Link
Medicare UPINE24649IL
Medicare PINL83256IL
Other05823820IL · Bcbs

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

Terry Balagna 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 ID3274435896
PECOS Enrollment IDI20120103000146
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 3

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.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
264 services253 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
76 services73 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
65 services64 patients

Hospital Affiliations CMS Care Compare

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

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number140135
Location2300 North Edward StreetDecatur, IL 62526 · Macon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62526 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Nurse Anesthetist, Certified Registered
2300 N EDWARD ST
DECATUR, IL 62526
Nurse Practitioner (Family)
2300 N EDWARD ST
DECATUR, IL 62526
Radiology (Diagnostic Radiology)
2300 N EDWARD ST
DECATUR, IL 62526
Physician Assistant
2300 N EDWARD ST
DECATUR, IL 62526
Dietitian, Registered
2300 N EDWARD ST
DECATUR, IL 62526
Physical Therapist
2300 N EDWARD ST
DECATUR, IL 62526
Nurse Anesthetist, Certified Registered
2300 N EDWARD ST
DECATUR, IL 62526
Anesthesiology
2300 N EDWARD ST
DECATUR, IL 62526

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 Terry Balagna's NPI number?

The NPI number for Terry Balagna is 1114022183. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Where is Terry Balagna located?

Terry Balagna practices at 2300 N Edward St, Decatur, IL 62526. The listed phone number is (217) 876-3000.

What is Terry Balagna's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Terry Balagna enrolled in Medicare?

Yes. Terry Balagna 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.

Is Terry Balagna affiliated with any hospitals?

According to CMS data, Terry Balagna is affiliated with Decatur Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Terry Balagna was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.