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SYLVIA BALABUSTA PA-C
NPI 1265930010
Physician Assistant in Denver, CO

Active since January 26, 2018PECOS EnrolledAccepts Medicare Assignment
950 E HARVARD AVE, DENVER, CO 80210(033) 715-9024 Get Directions Write a Review

NPPES record last updated: June 29, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 29, 2018, May 14, 2018 (2 updates tracked since 2018).

About Sylvia Balabusta Pa-c NPPES

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

SYLVIA BALABUSTA PA-C (NPI 1265930010) is an individual physician assistant in Denver, Colorado and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1265930010
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSYLVIA BALABUSTACredential: PA-C
Location Address950 E HARVARD AVEDenver, CO 80210
Mailing Address950 E Harvard Ave, Ste 570Denver, CO 80210-7003 · (303) 715-9024 · Fax (303) 715-5020
Phone(033) 715-9024
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateJanuary 26, 2018
Last NPPES UpdateJune 29, 20182 updates tracked since enumeration
✔ NPI 1265930010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
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.
950 E HARVARD AVE, Denver, CO 80210
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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

Sylvia Balabusta Pa-c 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 ID648527077
PECOS Enrollment IDI20180717001842
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80210 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
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
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.

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
95%1,026 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
100%431 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
31%537 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
49%538 patients2/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 177 patients
2%177 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
11 suppliers105 claims105 services$37.38 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
6 suppliers29 claims29 services$86.48 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers35 claims87 services$32.57 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
6 suppliers66 claims337 services$17.95 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
4 suppliers31 claims166 services$14.31 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
8 suppliers89 claims89 services$54.12 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 20

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

FOOT SPECIALIST ASSOCIATES P.C.
Podiatrist (Foot & Ankle Surgery)
950 E HARVARD AVE, 300
DENVER, CO 80210
Denver County (303) 722-6864
NEURODIAGNOSTICS GROUP, LLC
Specialist/Technologist, Other (Electroneurodiagnostic)
950 E HARVARD AVE, STE 570
DENVER, CO 80210
Denver County (303) 715-9024
DR. ADAM JONATHEN WOLFF M.D.
Psychiatry & Neurology (Neurology)
950 E HARVARD AVE, SUITE 570
DENVER, CO 80210
Denver County (303) 715-9024
JAMES SWINEHART MD
Specialist
950 E HARVARD AVE, SUITE 630
DENVER, CO 80210
Denver County (303) 744-7000
DR. JEFFREY A GIULLIAN M.D.
Internal Medicine (Nephrology)
950 E HARVARD AVE, SUITE 240
DENVER, CO 80210
Denver County (303) 871-0977
STEPHANIE WOMELDORF
Hearing Instrument Specialist
950 E HARVARD AVE, STE 620
DENVER, CO 80210
Denver County (303) 722-0886
PROFESSIONAL REFERRAL AND COUNSELLING SERVICE, INC.
Counselor (Mental Health)
950 E HARVARD AVE, SUITE 200
DENVER, CO 80210
Denver County (303) 733-2688
HARVARD PARK OPTICAL
Technician/Technologist (Optician)
950 E HARVARD AVE, SUITE 180
DENVER, CO 80210
Denver County (303) 777-7091

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 Sylvia Balabusta's NPI number?

The NPI number for Sylvia Balabusta is 1265930010. It was assigned to this individual provider in the NPPES registry on January 26, 2018.

Where is Sylvia Balabusta located?

Sylvia Balabusta practices at 950 E Harvard Ave, Denver, CO 80210. The listed phone number is (033) 715-9024.

What is Sylvia Balabusta's specialty?

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

Is Sylvia Balabusta enrolled in Medicare?

Yes. Sylvia Balabusta 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.

What insurance does Sylvia Balabusta accept?

Health plans from UnitedHealthcare list Sylvia Balabusta 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 Sylvia Balabusta was last updated on June 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.