NICHOLAS ANDREW BALLINGER
NPI 1235894106
Physician Assistant in Nashville, TN

Q: What is Nicholas Ballinger's NPI number?

The NPI number for Nicholas Ballinger is 1235894106. It was assigned to this individual provider in the NPPES registry on November 4, 2021.

Q: What is Nicholas Ballinger's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since November 04, 2021PECOS EnrolledAccepts Medicare Assignment

97.12/100

CMS Quality Rating

3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232(615) 936-2000 Get Directions Write a Review

NPPES record last updated: August 24, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 24, 2022, Jul 27, 2022, Jul 21, 2022 and 2 more (5 updates tracked since 2021).

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About Nicholas Andrew Ballinger NPPES

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

NICHOLAS ANDREW BALLINGER (NPI 1235894106) is an individual physician assistant in Nashville, Tennessee, licensed in Tennessee (4924) and active in the NPI registry since November 2021. He is enrolled in Medicare PECOS, is affiliated with Vanderbilt University Medical Center, and maintains a secondary practice location in Old Hickory.

NPPES Registry Identity

NPI1235894106

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameNICHOLAS ANDREW BALLINGER

Location Address3601 THE VANDERBILT CLINICNashville, TN 37232-2962

Mailing Address3841 Green Hills Village DrNashville, TN 37215-2691

Phone(615) 936-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateNovember 4, 2021

Last NPPES UpdateAugust 24, 20225 updates tracked since enumeration

NPPES CertifiedAugust 24, 2022

✔ NPI 1235894106 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TN · 4924

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

3601 THE VANDERBILT CLINIC, Nashville, TN 37232

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Secondary Practice Location 1

Location 12313 Patrick AveOld Hickory, TN 37138-2962 · Phone (443) 974-6183

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., BlueCross BlueShield of Tennessee, Oscar Insurance Company.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

Nicholas Andrew Ballinger 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 ID6002298460

PECOS Enrollment IDI20220801003195

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

22 services22 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

17 services17 patients

Hospital Affiliations CMS Care Compare

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

Vanderbilt University Medical Center

Acute Care Hospitals · Nashville, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440039

Location1211 Medical Center DriveNashville, TN 37232 · Davidson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37232 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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.

97.12/100

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

Scored through an Alternative Payment Model

Quality

85.64

Promoting Interoperability

100

Improvement Activities

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.

DR. ENGLISH FLACK MD

Pediatrics (Pediatric Cardiology)