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VAIDYANATHAPURAM BALAKRISHNAN M.D.
NPI 1326095548
Internal Medicine - Nephrology in Brighton, MA

Active since May 31, 2006PECOS EnrolledAccepts Medicare Assignment
11 NEVINS ST., SUITE 202 SEMC - MEDICAL SPECIALTIES PRACTICE, BRIGHTON, MA 02135(617) 779-6700(617) 779-6771 Get Directions Write a Review

NPPES record last updated: March 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 11, 2025, Dec 13, 2017 (2 updates tracked since 2017).

About Vaidyanathapuram Balakrishnan M.d. NPPES

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

VAIDYANATHAPURAM BALAKRISHNAN M.D. (NPI 1326095548) is an individual nephrology provider in Brighton, Massachusetts, licensed in Massachusetts (204354) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with St Elizabeth's Medical Center, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1326095548
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameVAIDYANATHAPURAM BALAKRISHNANCredential: M.D.
Location Address11 NEVINS ST., SUITE 202 SEMC - MEDICAL SPECIALTIES PRACTICEBrighton, MA 02135
Mailing AddressBmchs Provider Enrollment, 960 Massachusetts Ave Flr 2Boston, MA 02118
Phone(617) 779-6700
Fax(617) 779-6771
Sole ProprietorYes
Medical School CMSOtherGraduated 1984
Enumeration DateMay 31, 2006
Last NPPES UpdateMarch 11, 20252 updates tracked since enumeration
NPPES CertifiedMarch 7, 2025
✔ NPI 1326095548 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in MA · 204354
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
11 NEVINS ST., Brighton, MA 02135
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Vaidyanathapuram Balakrishnan 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 ID8628040300
PECOS Enrollment IDI20040812000287
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 7

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
244 services90 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.
219 services116 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
182 services43 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
89 services14 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.
79 services75 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.
47 services42 patients

Hospital Affiliations CMS Care Compare

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

St Elizabeth's Medical Center

Acute Care Hospitals · Brighton, MA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number220036
Location736 Cambridge StreetBrighton, MA 02135 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02135 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
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

Other Providers at the Same Location NPPES 11

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

ANN T SWEENEY M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
11 NEVINS ST., SUITE 202
BRIGHTON, MA 02135
Suffolk County (617) 779-6700
DR. EDUARDO ALBERTO VEGA PIZARRO MD
Surgery
11 NEVINS ST., SUITE 201
BOSTON, MA 02135
Suffolk County (617) 789-2442
HEATHER HUENE PA
Physician Assistant
11 NEVINS ST., SUITE 306
BRIGHTON, MA 02135
Suffolk County (617) 789-2045
VITOR HUGO MACHADO VILELA M.D.
Internal Medicine
11 NEVINS ST., SUITE 304
BOSTON, MA 02135
Suffolk County (617) 560-0712
MIHAELA BLENDEA M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
11 NEVINS ST., SUITE 202
BRIGHTON, MA 02135
Suffolk County (617) 779-6700
RACHEL MARIE MORRA PA
Physician Assistant
11 NEVINS ST., SUITE 306
BRIGHTON, MA 02135
Suffolk County (617) 789-2045
KAREN JEAN POLEY MD
Obstetrics & Gynecology
11 NEVINS ST., STE 407
BRIGHTON, MA 02135
Suffolk County (617) 783-0095
SAMARA PENA M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
11 NEVINS ST., SUITE 202
BRIGHTON, MA 02135
Suffolk County (617) 779-6700

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 Vaidyanathapuram Balakrishnan's NPI number?

The NPI number for Vaidyanathapuram Balakrishnan is 1326095548. It was assigned to this individual provider in the NPPES registry on May 31, 2006.

Where is Vaidyanathapuram Balakrishnan located?

Vaidyanathapuram Balakrishnan practices at 11 Nevins St. Suite 202 Semc - Medical Specialties Practice, Brighton, MA 02135. The listed phone number is (617) 779-6700.

What is Vaidyanathapuram Balakrishnan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Vaidyanathapuram Balakrishnan enrolled in Medicare?

Yes. Vaidyanathapuram Balakrishnan 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 Vaidyanathapuram Balakrishnan accept?

Health plans from Anthem Blue Cross and Blue Shield list Vaidyanathapuram Balakrishnan 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 Vaidyanathapuram Balakrishnan affiliated with any hospitals?

According to CMS data, Vaidyanathapuram Balakrishnan is affiliated with St Elizabeth's Medical Center.

When was this NPI record last updated?

The NPPES record for Vaidyanathapuram Balakrishnan was last updated on March 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.