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DR. MICHAEL W BALBUS M.D.
NPI 1245298041
Pediatrics - Neonatal-Perinatal Medicine in Bloomington, IN

Active since May 02, 2006PECOS EnrolledAccepts Medicare Assignment
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408(812) 353-9852(812) 353-9278 Get Directions Write a Review

NPPES record last updated: May 21, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 21, 2026, Aug 26, 2022, Feb 5, 2020 (3 updates tracked since 2020).

About Dr. Michael W Balbus M.d. NPPES

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

DR. MICHAEL W BALBUS M.D. (NPI 1245298041) is an individual neonatal-perinatal medicine provider in Bloomington, Indiana, licensed in Arizona (79957) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of State University Of New York At Stony Brook, School Of Medicine (1985).

NPPES Registry Identity

NPI1245298041
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NameDR. MICHAEL W BALBUSCredential: M.D.
Location Address2651 E DISCOVERY PKWYBloomington, IN 47408-9059
Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959
Phone(812) 353-9852
Fax(812) 353-9278
Sole ProprietorNo
Medical School CMSState University Of New York At Stony Brook, School Of MedicineGraduated 1985
Enumeration DateMay 2, 2006
Last NPPES UpdateMay 21, 20263 updates tracked since enumeration
NPPES CertifiedMay 21, 2026
✔ NPI 1245298041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
Licenses✔ Licensed in AZ · 79957✔ Licensed in IN · 01060372A✔ Licensed in NY · 168666-01✔ Licensed in VA · 0101259640
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Also ListedPediatricsTaxonomy 208000000X · License 036-091626 (IL)
2651 E DISCOVERY PKWY, Bloomington, IN 47408
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Secondary Practice Location 1

Location 1225 East Chicago Avenue, Box 152Chicago, IL 60611-2605 · Phone (312) 227-7413 · Fax (312) 227-9525

Other Identifiers 2

Other021622158IL · Group Blue Shield Number
Medicaid036091626IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc.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

Dr. Michael W Balbus M.d. 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 ID4385651488
PECOS Enrollment IDI20060315000156
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

3

Medicare enrollment records show Michael Balbus reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Indiana University Health Southern Indiana Physicians, LLC
4.1 mi
Multi-Specialty
2651 E DISCOVERY PKWY
Bloomington, IN 47408
  • Reassigned Medicare billing, Indiana enrollment
  • 783 clinicians in this Medicare group
NPI 1013953983 (812) 353-5252
Carle Health Medical Group
112 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300
Lurie Children's Medical Group Inc
197 mi
Pediatrics
225 E CHICAGO AVE
Chicago, IL 60611
  • Reassigned Medicare billing, Illinois enrollment
  • 826 clinicians in this Medicare group
NPI 1518064716 (312) 227-6412

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

KIERNAN MCCORMICK
Student in an Organized Health Care Education/Training Program
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 353-5252
DR. JAMES ALEXANDER ISOM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 918-3336
SHERYL ANN KNOTT NP
Clinical Nurse Specialist
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 676-4444
INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS, LLC
Clinic/Center (Multi-Specialty)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 353-5252
MRS. MEGAN EMILY MCGLOTHLIN NP
Nurse Practitioner (Gerontology)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 676-4144
GAVEN ANDREW MOORE PA-C
Physician Assistant
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 334-5081
BERNARD LAMAR HARDY II MD
Internal Medicine
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 676-4102
DR. DAVID AUSTIN DUNCAN DO
Psychiatry & Neurology (Psychiatry)
2651 E DISCOVERY PKWY
BLOOMINGTON, IN 47408
Monroe County (812) 353-5630

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 Balbus's NPI number?

The NPI number for Michael Balbus is 1245298041. It was assigned to this individual provider in the NPPES registry on May 2, 2006.

Where is Michael Balbus located?

Michael Balbus practices at 2651 E Discovery Pkwy, Bloomington, IN 47408. The listed phone number is (812) 353-9852.

What is Michael Balbus's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Michael Balbus enrolled in Medicare?

Yes. Michael Balbus 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 Michael Balbus's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Balbus reassigns Medicare benefits to 3 organizations: Indiana University Health Southern Indiana Physicians, LLC (Bloomington, IN), Carle Health Medical Group (Urbana, IL) and Lurie Children's Medical Group Inc (Chicago, IL). 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 Michael Balbus's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Balbus accept?

Health plans from Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc list Michael Balbus 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 Michael Balbus was last updated on May 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.