DR. KHADIJAT OMOLOLA BALOGUN M.D
NPI 1124310743
Internal Medicine - Gastroenterology in Manchester, CT

Q: What is Khadijat Balogun's NPI number?

The NPI number for Khadijat Balogun is 1124310743. It was assigned to this individual provider in the NPPES registry on May 16, 2011.

Q: What is Khadijat Balogun's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Khadijat Balogun was last updated on July 21, 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.

Active since May 16, 2011PECOS EnrolledAccepts Medicare Assignment

353 MAIN ST, MANCHESTER, CT 06040(860) 649-3477(860) 649-0011 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 21, 2022, Jul 26, 2017 (2 updates tracked since 2017).

On this page

About Dr. Khadijat Omolola Balogun M.d NPPES

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

DR. KHADIJAT OMOLOLA BALOGUN M.D (NPI 1124310743) is an individual gastroenterology provider in Manchester, Connecticut, licensed in Connecticut (56518) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS, is affiliated with University Of Md Charles Regional Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1124310743

Entity TypeIndividualFemale

Primary Taxonomy207RG0100X

Provider Legal NameDR. KHADIJAT OMOLOLA BALOGUNCredential: M.D

Location Address353 MAIN STManchester, CT 06040-4145

Mailing Address353 Main StManchester, CT 06040-4145 · (860) 649-3477 · Fax (860) 649-0011

Phone(860) 649-3477

Fax(860) 649-0011

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateMay 16, 2011

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1124310743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in CT · 56518

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

353 MAIN ST, Manchester, CT 06040

Open in Google Maps ↗

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. Khadijat Omolola Balogun 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 ID9537431721

PECOS Enrollment IDI20210914002333, I20220222001399

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 Reassignment

Medicare enrollment records show Khadijat Balogun reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gastrointestinal Associates Of Maryland PA

319 mi

Gastroenterology

3510 OLD WASHINGTON RD STE 201
Waldorf, MD 20602

Reassigned Medicare billing, Maryland enrollment
11 clinicians in this Medicare group

NPI 1164404125 (301) 645-8035

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 10

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

103 services103 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.

99 services72 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

97 services97 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

79 services79 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

55 services54 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

55 services55 patients

Hospital Affiliations CMS Care Compare 2

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

University Of MD Charles Regional Medical Center

Acute Care Hospitals · La Plata, MD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210035

Location5 Garrett AvenueLa Plata, MD 20646 · Charles County

Emergency services Birthing friendly

Adventist Healthcare Fort Washington Medical Ctr

Acute Care Hospitals · Fort Washington, MD

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number210060

Location11711 Livingston RoadFort Washington, MD 20744 · Prince Georges County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06040 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

$138.84 typical visit price

range $60.82 – $183.10

Typical copayment $34.71 (range $15.20 – $45.77)

Most-billed visit code 99204

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

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 9

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

PETER S BUCH MD

Internal Medicine (Gastroenterology)