MICHAEL T BALLAS MD
NPI 1225088651
Family Medicine in Minster, OH

Q: What is Michael Ballas's NPI number?

The NPI number for Michael Ballas is 1225088651. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Q: What is Michael Ballas's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Ballas was last updated on December 8, 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.

Active since May 10, 2006PECOS EnrolledAccepts Medicare Assignment

84.78/100

CMS Quality Rating

11531 STATE ROUTE 66, MINSTER, OH 45865(937) 295-2949(419) 628-0342 Get Directions Write a Review

NPPES record last updated: December 8, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Michael T Ballas Md NPPES

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

MICHAEL T BALLAS MD (NPI 1225088651) is an individual family medicine provider in Minster, Ohio, licensed in Ohio (35-06-7026-B) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Wilson Memorial Hospital, and is a graduate of Ohio State University College Of Medicine (1993).

NPPES Registry Identity

NPI1225088651

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMICHAEL T BALLASCredential: MD

Location Address11531 STATE ROUTE 66Minster, OH 45865-9303

Mailing Address915 West Michigan StSidney, OH 45365-2401 · (937) 295-2949 · Fax (419) 628-0342

Phone(937) 295-2949

Fax(419) 628-0342

Sole ProprietorNo

Medical School CMSOhio State University College Of MedicineGraduated 1993

Enumeration DateMay 10, 2006

Last NPPES UpdateDecember 8, 2020

NPPES CertifiedDecember 8, 2020

✔ NPI 1225088651 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OH · 35-06-7026-B

Definition

Family 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.

11531 STATE ROUTE 66, Minster, OH 45865

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Other Identifiers 1

Medicaid0101106OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Michael T Ballas 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 ID9739192964

PECOS Enrollment IDI20060711000063

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 Michael Ballas reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wilson Care, LLC

12 mi

Family Medicine

915 W. MICHIGAN STREET, SUITE 204
Sidney, OH 45365

Reassigned Medicare billing, Ohio enrollment
69 clinicians in this Medicare group

NPI 1205886926 (937) 494-5940

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 16

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 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.

456 services248 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

396 services210 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.

279 services192 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

66 services65 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

66 services65 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

55 services50 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

54 services54 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

51 services51 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

48 services48 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

46 services46 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

45 services41 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

33 services23 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

28 services14 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

24 services22 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

21 services20 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

13 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Wilson Memorial Hospital

Acute Care Hospitals · Sidney, OH

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360013

Location915 West Michigan StreetSidney, OH 45365 · Shelby County

Emergency services Birthing friendly

Upper Valley Medical Center

Acute Care Hospitals · Troy, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360174

Location3130 North County Road 25ATroy, OH 45373 · Miami County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45865 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

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.

84.78/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

75.09

Promoting Interoperability

100

Improvement Activities

Cost

74.18

Referred Medical Equipment & Supplies CMS DME claims 13

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

10 suppliers61 claims150 services$5.83 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

4 suppliers12 claims13 services$1.13 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers23 claims23 services$115.88 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

5 suppliers34 claims65 services$43.37 avg. paid by Medicare

Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034

DME-Other DME · category DE001N

5 suppliers13 claims13 services$74.73 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

6 suppliers30 claims30 services$24.45 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

DENA M PELLETIER CNP

Nurse Practitioner

11531 STATE ROUTE 66
MINSTER, OH 45865

Auglaize County (937) 295-2949

DR. KAREN A BALLAS M.D.

Family Medicine

11531 STATE ROUTE 66
MINSTER, OH 45865

Auglaize County (937) 295-2949

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 Michael Ballas's NPI number?

The NPI number for Michael Ballas is 1225088651. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Where is Michael Ballas located?

Michael Ballas practices at 11531 State Route 66, Minster, OH 45865. The listed phone number is (937) 295-2949.

What is Michael Ballas's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Michael Ballas enrolled in Medicare?

Yes. Michael Ballas 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 Michael Ballas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Ballas reassigns Medicare benefits to Wilson Care, LLC (Sidney, OH). 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 Michael Ballas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Ballas accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Michael Ballas 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 Michael Ballas affiliated with any hospitals?

According to CMS data, Michael Ballas is affiliated with Wilson Memorial Hospital and Upper Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Ballas was last updated on December 8, 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.