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ANDREW M BALSTER MD
NPI 1356803159
Internal Medicine in Milwaukie, OR

Active since April 02, 2019PECOS EnrolledAccepts Medicare Assignment
97.51/100
CMS Quality Rating
10150 SE 32ND AVE, MILWAUKIE, OR 97222(503) 513-8641 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 2, 2022, Oct 4, 2021, Apr 2, 2019 (3 updates tracked since 2019).

About Andrew M Balster Md NPPES

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

ANDREW M BALSTER MD (NPI 1356803159) is an individual internal medicine provider in Milwaukie, Oregon, licensed in Oregon (MD199589) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, is affiliated with Providence Portland Medical Center, and is a graduate of Georgetown University School Of Medicine (2019).

NPPES Registry Identity

NPI1356803159
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameANDREW M BALSTERCredential: MD
Location Address10150 SE 32ND AVEMilwaukie, OR 97222-6516
Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494
Phone(503) 513-8641
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 2019
Enumeration DateApril 2, 2019
Last NPPES UpdateDecember 2, 20223 updates tracked since enumeration
NPPES CertifiedDecember 2, 2022
✔ NPI 1356803159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OR · MD199589
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
10150 SE 32ND AVE, Milwaukie, OR 97222
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.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

Andrew M Balster 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 ID9032448204
PECOS Enrollment IDI20220808003366
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
151 services75 patients
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.
62 services38 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
58 services58 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
49 services21 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.
30 services29 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380061
Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County
Emergency services Birthing friendly

Providence Hood River Memorial Hospital

Critical Access Hospitals · Hood River, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number381318
Location810 12th StreetHood River, OR 97031 · Hood River County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97222 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
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

97.51/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality97.88
Promoting Interoperability100
Improvement Activities40
Cost84.56

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.

JONATHAN HATTENHAUER D.O.
Internal Medicine (Gastroenterology)
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 215-5895
JANINE TRACY VANSANT MD
Internal Medicine
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 513-8641
DR. JAMES EDWARD MARAS M.D.
Emergency Medicine
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 297-6334
STEVEN J REDMOND MD
Hospitalist
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 513-8695
CHAD BYARS M.D.
Emergency Medicine
10150 SE 32ND AVE
PORTLAND, OR 97222
Clackamas County (503) 513-1031
DR. MARK N. ROBERTS D.O.
Emergency Medicine
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 297-6334
PROVIDENCE MILWAUKIE HOSPITAL
General Acute Care Hospital
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 513-8338
DR. PAUL VINCENT SKILES M.D.
Emergency Medicine
10150 SE 32ND AVE
MILWAUKIE, OR 97222
Clackamas County (503) 297-6334

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 Andrew Balster's NPI number?

The NPI number for Andrew Balster is 1356803159. It was assigned to this individual provider in the NPPES registry on April 2, 2019.

Where is Andrew Balster located?

Andrew Balster practices at 10150 SE 32nd Ave, Milwaukie, OR 97222. The listed phone number is (503) 513-8641.

What is Andrew Balster's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Andrew Balster enrolled in Medicare?

Yes. Andrew Balster 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 Andrew Balster accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Andrew Balster 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 Andrew Balster affiliated with any hospitals?

According to CMS data, Andrew Balster is affiliated with Providence Portland Medical Center and Providence Hood River Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Balster was last updated on December 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.