DR. SUSAN WANDA BALKE DO NPI 1124013925

Family Medicine in Marianna, AR

NPI 1124013925 Individual Female Years of Experience 39 Family Medicine PECOS Enrolled May Accept Medicare Approved Payment

About SUSAN BALKE

Susan Balke is a primary care provider established in Marianna, Arkansas and her medical specialization is family medicine with more than 39 years of experience. She graduated from R Franklin University Of Med & Sci/chicago Medical School in 1983. The NPI number of Susan Balke is 1124013925 and was assigned on September 2005. The practitioner's primary taxonomy code is 207Q00000X with license number N6963 (AR). The provider is registered as an individual and her NPI record was last updated 14 years ago.

A primary care provider (PCP) like Dr. Susan Wanda Balke Do sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Susan Balke is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Susan Balke is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services. According to Medicare claims data she has hospital affiliations with Forrest City Medical Center and Helena Regional Medical Center.

NPI

1124013925

Provider NameDR. SUSAN WANDA BALKE DO
Provider Location Address171 CHERRY ST MARIANNA, AR 72360
Provider Mailing Address171 CHERRY ST MARIANNA, AR 72360
GenderFemale
NPI Entity TypeIndividual
Medical School NameR FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Graduation Year1983
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date09-18-2005
Last Update Date09-07-2007


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.N6963
License StateAR
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

DR. SUSAN WANDA BALKE DO
171 CHERRY ST
MARIANNA, AR
ZIP 72360
Phone: (870) 295-6205

Get Directions


Mailing Address

DR. SUSAN WANDA BALKE DO
171 CHERRY ST
MARIANNA, AR
ZIP 72360
Phone: (870) 295-6205



Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID8628063229
PECOS Enrollment IDI20040414001672
Accepts Medicare Assignment? Maybe "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Clinician Utilization

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.

  • 185Urinalysis, manual test (HCPCS:81002)
  • 180Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • 120Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial im (HCPCS:G0179)
  • 55Hemoglobin A1C level (HCPCS:83036)
  • 51Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple (HCPCS:G0180)
  • 42Blood glucose (sugar) test performed by hand-held instrument (HCPCS:82962)
  • 40Stool analysis for blood to screen for colon tumors (HCPCS:82270)
  • 38Administration of influenza virus vaccine (HCPCS:G0008)
  • 11Ultrasound study of arteries of both arms and legs (HCPCS:93922)

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Susan Balke is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
FORREST CITY MEDICAL CENTER1601 NEWCASTLE ROAD
FORREST CITY, AR 72335
(870) 261-0000Acute Care Hospitals40019
HELENA REGIONAL MEDICAL CENTER1801 MARTIN LUTHER KING JR DRIVE
HELENA, AR 72342
(870) 338-5800Acute Care Hospitals40085

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
C68168MEDICARE UPIN (02)
51392MEDICARE ID-TYPE UNSPECIFIED (04)
111863003MEDICAID (05)AR

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.