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SERGIO BALCAZAR MD
NPI 1346295862
Psychiatry & Neurology - Psychiatry in Miramar, FL

Active since May 23, 2006PECOS Enrolled
5062 SW 139 TERR, MIRAMAR, FL 33027(954) 494-0391 Get Directions Write a Review

NPPES record last updated: November 14, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 14, 2023, Oct 4, 2023 (2 updates tracked since 2023).

About Sergio Balcazar Md NPPES

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

SERGIO BALCAZAR MD (NPI 1346295862) is an individual psychiatry provider in Miramar, Florida, licensed in Florida (ME63475) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346295862
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameSERGIO BALCAZARCredential: MD
Location Address5062 SW 139 TERRMiramar, FL 33027
Mailing Address5062 Sw 139 TerrMiramar, FL 33027 · (954) 494-0391
Phone(954) 494-0391
Sole ProprietorYes
Enumeration DateMay 23, 2006
Last NPPES UpdateNovember 14, 20232 updates tracked since enumeration
NPPES CertifiedNovember 14, 2023
✔ NPI 1346295862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in FL · ME63475
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedGeneral PracticeTaxonomy 208D00000X · License ME63475 (FL)
5062 SW 139 TERR, Miramar, FL 33027
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sergio Balcazar Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Sergio Balcazar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medical Central, LLC
111 mi
Mental Health (Including Community Mental Health Center)
114 DEL PRADO BLVD S # 100
Cape Coral, FL 33990
  • Reassigned Medicare billing, Florida enrollment
  • 3 clinicians in this Medicare group
NPI 1134628951 (239) 471-2874

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33027 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
$179.05 typical visit price
range $58.56 – $179.05
Typical copayment $44.76 (range $14.64 – $44.76)
Most-billed visit code 99205
Established Patient
$73.00 typical visit price
range $18.44 – $144.68
Typical copayment $18.25 (range $4.61 – $36.17)
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.

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 Sergio Balcazar's NPI number?

The NPI number for Sergio Balcazar is 1346295862. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Sergio Balcazar located?

Sergio Balcazar practices at 5062 SW 139 Terr, Miramar, FL 33027. The listed phone number is (954) 494-0391.

What is Sergio Balcazar's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Sergio Balcazar enrolled in Medicare?

Yes. Sergio Balcazar is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sergio Balcazar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sergio Balcazar reassigns Medicare benefits to Medical Central, LLC (Cape Coral, FL). The 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 Sergio Balcazar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sergio Balcazar accept?

Health plans from Ambetter Health, Ambetter of Alabama and Molina Healthcare list Sergio Balcazar 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 Sergio Balcazar was last updated on November 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.