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DANIEL BALIKOV MD, PHD
NPI 1215598024
Ophthalmology - Retina Specialist in Chicago, IL

Active since June 24, 2019PECOS EnrolledAccepts Medicare Assignment
81.31/100
CMS Quality Rating
4822 S COTTAGE GROVE AVE STE 2-300, CHICAGO, IL 60061(312) 695-8150(312) 921-1071 Get Directions Write a Review

NPPES record last updated: August 28, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Daniel Balikov Md, Phd NPPES

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

DANIEL BALIKOV MD, PHD (NPI 1215598024) is an individual retina specialist in Chicago, Illinois, licensed in Illinois (036176089) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS, is affiliated with Northwestern Memorial Hospital, and maintains a secondary practice location in Miami.

NPPES Registry Identity

NPI1215598024
Entity TypeIndividualMale
Primary Taxonomy207WX0107X
Provider Legal NameDANIEL BALIKOVCredential: MD, PHD
Location Address4822 S COTTAGE GROVE AVE STE 2-300Chicago, IL 60061
Mailing Address4822 S Cottage Grove Ave Ste 2-300Chicago, IL 60061 · (312) 695-8150 · Fax (312) 921-1071
Phone(312) 695-8150
Fax(312) 921-1071
Sole ProprietorNo
Medical School CMSVanderbilt University School Of MedicineGraduated 2019
Enumeration DateJune 24, 2019
Last NPPES UpdateAugust 28, 2025
NPPES CertifiedAugust 20, 2025
✔ NPI 1215598024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in IL · 036176089
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License ME161907 (FL)
4822 S COTTAGE GROVE AVE STE 2-300, Chicago, IL 60061
Open in Google Maps ↗

Secondary Practice Location 1

Location 1900 NW 17th StMiami, FL 33136-1119 · Phone (305) 243-2020

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Molina Healthcare.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

Daniel Balikov Md, Phd 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 ID8426382904
PECOS Enrollment IDI20250901000626
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 Reassignments

2

Medicare enrollment records show Daniel Balikov reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Northwestern Medical Faculty Foundation
37 mi
Multi-Specialty
DEPT 5777
Carol Stream, IL 60122
  • Reassigned Medicare billing, Illinois enrollment
  • 4,817 clinicians in this Medicare group
NPI 1346235314 (855) 694-2866
University Of Miami
1,116 mi
Ambulatory Surgical
7103 FAIRWAY DR
Palm Beach Gardens, FL 33418
  • Reassigned Medicare billing, Florida enrollment
  • 3,639 clinicians in this Medicare group
NPI 1346317039 (561) 515-1500

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 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.

Emergency department visit with low level of medical decision making 99283
An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
36 services36 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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140281
Location251 E Huron StChicago, IL 60611 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60061 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
$137.43 typical visit price
range $59.81 – $181.38
Typical copayment $34.35 (range $14.95 – $45.34)
Most-billed visit code 99204
Established Patient
$74.38 typical visit price
range $19.15 – $147.12
Typical copayment $18.59 (range $4.78 – $36.78)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.31/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.45
Promoting Interoperability100
Improvement Activities40
Cost50.59

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 Daniel Balikov's NPI number?

The NPI number for Daniel Balikov is 1215598024. It was assigned to this individual provider in the NPPES registry on June 24, 2019.

Where is Daniel Balikov located?

Daniel Balikov practices at 4822 S Cottage Grove Ave Ste 2-300, Chicago, IL 60061. The listed phone number is (312) 695-8150.

What is Daniel Balikov's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Daniel Balikov enrolled in Medicare?

Yes. Daniel Balikov 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 organizations bill Medicare for Daniel Balikov's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Daniel Balikov reassigns Medicare benefits to 2 organizations: Northwestern Medical Faculty Foundation (Carol Stream, IL) and University Of Miami (Palm Beach Gardens, FL). Each 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 Daniel Balikov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Daniel Balikov accept?

Health plans from AmeriHealth Caritas Next and Molina Healthcare list Daniel Balikov 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 Daniel Balikov affiliated with any hospitals?

According to CMS data, Daniel Balikov is affiliated with Northwestern Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Daniel Balikov was last updated on August 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.