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BALSAM S ELHAMMALI MD
NPI 1215037205
Internal Medicine in Atlanta, GA

Active since September 22, 2006PECOS EnrolledAccepts Medicare Assignment
80 JESSE HILL JR DR STE 100, ATLANTA, GA 30303(404) 616-7578 Get Directions Write a Review

NPPES record last updated: July 6, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 6, 2021, Sep 25, 2018 (2 updates tracked since 2018).

About Balsam S Elhammali Md NPPES

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

BALSAM S ELHAMMALI MD (NPI 1215037205) is an individual internal medicine provider in Atlanta, Georgia, licensed in Georgia (58412) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Grady Memorial Hospital, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1215037205
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameBALSAM S ELHAMMALICredential: MD
Location Address80 JESSE HILL JR DR STE 100Atlanta, GA 30303-3031
Mailing Address720 Westview Drive Sw, Harris Bldg., 100-aAtlanta, GA 30310 · (404) 756-1400
Phone(404) 616-7578
Sole ProprietorNo
Medical School CMSOtherGraduated 1987
Enumeration DateSeptember 22, 2006
Last NPPES UpdateJuly 6, 20212 updates tracked since enumeration
NPPES CertifiedJuly 6, 2021
✔ NPI 1215037205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 58412
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
80 JESSE HILL JR DR STE 100, Atlanta, GA 30303
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Other Identifiers 1

Medicaid992399413CGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

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

Balsam S Elhammali Md 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 ID8022018035
PECOS Enrollment IDI20061221000433
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 2

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.

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.
50 services44 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
25 services23 patients

Hospital Affiliations CMS Care Compare

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

Grady Memorial Hospital

Acute Care Hospitals · Atlanta, GA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110079
Location80 Jesse Hill, Jr Drive SEAtlanta, GA 30303 · Fulton County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30303 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

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 Balsam Elhammali's NPI number?

The NPI number for Balsam Elhammali is 1215037205. It was assigned to this individual provider in the NPPES registry on September 22, 2006.

Where is Balsam Elhammali located?

Balsam Elhammali practices at 80 Jesse Hill Jr Dr Ste 100, Atlanta, GA 30303. The listed phone number is (404) 616-7578.

What is Balsam Elhammali's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Balsam Elhammali enrolled in Medicare?

Yes. Balsam Elhammali 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.

What insurance does Balsam Elhammali accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Balsam Elhammali 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 Balsam Elhammali affiliated with any hospitals?

According to CMS data, Balsam Elhammali is affiliated with Grady Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Balsam Elhammali was last updated on July 6, 2021. 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.