PABLO E BALBOA-MARCIACK MD
NPI 1255357067
Family Medicine in Calhoun, GA

Q: What is Pablo Balboa-marciack's NPI number?

The NPI number for Pablo Balboa-marciack is 1255357067. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Q: What is Pablo Balboa-marciack's specialty?

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

Active since July 14, 2006PECOS EnrolledAccepts Medicare Assignment

83.08/100

CMS Quality Rating

100 HOSPITAL CT, CALHOUN, GA 30701(706) 602-8200(706) 602-1354 Get Directions Write a Review

NPPES record last updated: December 13, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Pablo E Balboa-marciack Md NPPES

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

PABLO E BALBOA-MARCIACK MD (NPI 1255357067) is an individual family medicine provider in Calhoun, Georgia, licensed in Georgia (055409) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Adventhealth Gordon, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1255357067

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePABLO E BALBOA-MARCIACKCredential: MD

Location Address100 HOSPITAL CTCalhoun, GA 30701-2077

Mailing AddressPo Box 12938, C/o Clinic ManagementCalhoun, GA 30703 · (706) 602-7800

Phone(706) 602-8200

Fax(706) 602-1354

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateJuly 14, 2006

Last NPPES UpdateDecember 13, 2018

✔ NPI 1255357067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 055409

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.

100 HOSPITAL CT, Calhoun, GA 30701

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Other Identifiers 1

Medicaid135418395CGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Pablo E Balboa-marciack 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 ID244292886

PECOS Enrollment IDI20041027000453

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 10

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.

Injection, dexamethasone sodium phosphate, 1 mg J1100

Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.

666 services95 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.

355 services157 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

140 services109 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.

125 services108 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

111 services47 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

60 services59 patients

Hospital Affiliations CMS Care Compare

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

Adventhealth Gordon

Acute Care Hospitals · Calhoun, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number110023

Location1035 Red Bud RoadCalhoun, GA 30701 · Gordon County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30701 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

83.08/100

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

Scored as part of a group practice

Quality

68.9

Promoting Interoperability

100

Improvement Activities

Cost

69.57

Referred Medical Equipment & Supplies CMS DME claims 4

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

5 suppliers19 claims38 services$5.89 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

4 suppliers27 claims28 services$20.72 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers19 claims19 services$7.92 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers27 claims28 services$112.12 avg. paid by Medicare

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

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Other Providers at the Same Location NPPES 7

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

JEREMY SETH BAKER NP-C

Nurse Practitioner (Family)