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EVA BALFANZ LPC
NPI 1154796357
Counselor - Professional in Sun Prairie, WI

Active since December 14, 2015PECOS EnrolledAccepts Medicare Assignment
10 TOWER DR, SUN PRAIRIE, WI 53590(608) 825-3008(608) 825-3793 Get Directions Write a Review

NPPES record last updated: December 30, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 30, 2020, Feb 28, 2019, Dec 14, 2015 (3 updates tracked since 2015).

About Eva Balfanz Lpc NPPES

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

EVA BALFANZ LPC (NPI 1154796357) is an individual professional provider in Sun Prairie, Wisconsin, licensed in Wisconsin (5195-125) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1154796357
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameEVA BALFANZCredential: LPC
Location Address10 TOWER DRSun Prairie, WI 53590-1239
Mailing Address10 Tower DrSun Prairie, WI 53590-1239 · (608) 825-3500
Phone(608) 825-3008
Fax(608) 825-3793
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateDecember 14, 2015
Last NPPES UpdateDecember 30, 20203 updates tracked since enumeration
NPPES CertifiedDecember 30, 2020
✔ NPI 1154796357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 5195-125
10 TOWER DR, Sun Prairie, WI 53590
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean 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

Eva Balfanz Lpc 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 ID3375987506
PECOS Enrollment IDI20240215003249
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 Eva Balfanz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Dean Health Systems, Inc
14 mi
Allergy & Immunology
1211 FISH HATCHERY RD
Madison, WI 53715
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,377 clinicians in this Medicare group
NPI 1053358846 (608) 252-8000

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

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.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
75 services18 patients

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.

TAMI R LESLIE AU.D.
Audiologist
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3500
MRS. ELIZABETH MARY ROE PT
Physical Therapist
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3500
JENNIFER MARIE GROEHLER O.D.
Optometrist
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3008
DR. MELISSA MCGOWAN TERRILL O.D.
Optometrist
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3008
JOANNE L TAYLOR MD
Pediatrics
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3008
LEO A SCHUG MD
Internal Medicine
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3008
DIANA V FLINT M.D
Family Medicine
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3500
KATE M BLANK PA-C
Physician Assistant
10 TOWER DR
SUN PRAIRIE, WI 53590
Dane County (608) 825-3500

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 Eva Balfanz's NPI number?

The NPI number for Eva Balfanz is 1154796357. It was assigned to this individual provider in the NPPES registry on December 14, 2015.

Where is Eva Balfanz located?

Eva Balfanz practices at 10 Tower Dr, Sun Prairie, WI 53590. The listed phone number is (608) 825-3008.

What is Eva Balfanz's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Eva Balfanz enrolled in Medicare?

Yes. Eva Balfanz 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 organization bills Medicare for Eva Balfanz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Eva Balfanz reassigns Medicare benefits to Dean Health Systems, Inc (Madison, WI). The 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 Eva Balfanz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Eva Balfanz accept?

Health plans from Anthem Blue Cross and Blue Shield and Dean Health Plan list Eva Balfanz 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.

When was this NPI record last updated?

The NPPES record for Eva Balfanz was last updated on December 30, 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.