PAOLO NINO BALMASEDA
NPI 1326427105
Family Medicine in Novi, MI

Q: What is Paolo Balmaseda's NPI number?

The NPI number for Paolo Balmaseda is 1326427105. It was assigned to this individual provider in the NPPES registry on May 26, 2015.

Q: What is Paolo Balmaseda's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Paolo Balmaseda was last updated on July 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since May 26, 2015PECOS EnrolledAccepts Medicare Assignment

26750 PROVIDENCE PKWY STE 210, NOVI, MI 48374(248) 465-4782(248) 465-4852 Get Directions Write a Review

NPPES record last updated: July 29, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 29, 2019, Jul 17, 2019 (2 updates tracked since 2019).

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About Paolo Nino Balmaseda NPPES

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

PAOLO NINO BALMASEDA (NPI 1326427105) is an individual family medicine provider in Novi, Michigan, licensed in Michigan (4301500673) and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1326427105

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePAOLO NINO BALMASEDA

Location Address26750 PROVIDENCE PKWY STE 210Novi, MI 48374-1212

Mailing Address26750 Providence Pkwy Ste 210Novi, MI 48374-1212 · (248) 465-4782 · Fax (248) 465-4852

Phone(248) 465-4782

Fax(248) 465-4852

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateMay 26, 2015

Last NPPES UpdateJuly 29, 20192 updates tracked since enumeration

✔ NPI 1326427105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4301500673

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.

Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X · License 4301500673 (MI)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

26750 PROVIDENCE PKWY STE 210, Novi, MI 48374

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Secondary Practice Location 1

Location 110122 E 10th St, Ste 100Indianapolis, IN 46229 · Phone (317) 355-5717

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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

Paolo Nino Balmaseda 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 ID3577884469

PECOS Enrollment IDI20190817000190

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 6

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.

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.

124 services104 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.

77 services56 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

73 services73 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

72 services72 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

24 services24 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

21 services21 patients

Hospital Affiliations CMS Care Compare

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

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230019

Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48374 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

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Other Providers at the Same Location NPPES

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

CHACE MICHAEL DAVIES D.O.

Family Medicine (Sports Medicine)

26750 PROVIDENCE PKWY STE 210
NOVI, MI 48374

Oakland County (248) 465-4469

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 Paolo Balmaseda's NPI number?

The NPI number for Paolo Balmaseda is 1326427105. It was assigned to this individual provider in the NPPES registry on May 26, 2015.

Where is Paolo Balmaseda located?

Paolo Balmaseda practices at 26750 Providence Pkwy Ste 210, Novi, MI 48374. The listed phone number is (248) 465-4782.

What is Paolo Balmaseda's specialty?

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

Is Paolo Balmaseda enrolled in Medicare?

Yes. Paolo Balmaseda 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 Paolo Balmaseda accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Paolo Balmaseda 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 Paolo Balmaseda affiliated with any hospitals?

According to CMS data, Paolo Balmaseda is affiliated with Ascension Providence Hospital, Southfield And Novi.

When was this NPI record last updated?

The NPPES record for Paolo Balmaseda was last updated on July 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.