LUKE BALMER
NPI 1366067373
Nurse Practitioner - Adult Health in Richmond, VA

Active since June 15, 2020PECOS EnrolledAccepts Medicare Assignment
76.23/100
CMS Quality Rating
9000 STONY POINT PKWY, RICHMOND, VA 23235(804) 828-2161(804) 998-1255 Get Directions Write a Review

NPPES record last updated: December 30, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 30, 2022, Jun 15, 2020 (2 updates tracked since 2020).

About Luke Balmer NPPES

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

LUKE BALMER (NPI 1366067373) is an individual adult health provider in Richmond, Virginia, licensed in Virginia (0024179499) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, is affiliated with Medical College Of Virginia Hospitals, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1366067373
Entity TypeIndividualMale
Primary Taxonomy363LA2200X
Provider Legal NameLUKE BALMER
Location Address9000 STONY POINT PKWYRichmond, VA 23235-1900
Mailing Address9000 Stony Point PkwyRichmond, VA 23235-1900 · (804) 828-2161 · Fax (804) 998-1255
Fax(804) 998-1255
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateJune 15, 2020
Last NPPES UpdateDecember 30, 20222 updates tracked since enumeration
NPPES CertifiedDecember 30, 2022
NPI 1366067373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License Licensed in VA · 0024179499
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License AG06200129 (VA), 0024179499 (VA)
9000 STONY POINT PKWY, Richmond, VA 23235

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

Luke Balmer 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 ID3476965435
PECOS Enrollment IDI20201215003302
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 3

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 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.
336 services245 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.
143 services112 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Medical College Of Virginia Hospitals

Acute Care Hospitals · Richmond, VA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number490032
LocationPost Office Box 980510 1250 East Marshall StreetRichmond, VA 23298 · Richmond City County
Emergency services Birthing friendly

Vcu Health Tappahannock Hospital

Acute Care Hospitals · Tappahannock, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490084
Location618 Hospital RoadTappahannock, VA 22560 · Essex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23235 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

76.23/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.58
Promoting Interoperability100
Improvement Activities40
Cost56.18

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.

Internal Medicine (Pulmonary Disease)
9000 STONY POINT PKWY
RICHMOND, VA 23235
Physical Medicine & Rehabilitation
9000 STONY POINT PKWY
RICHMOND, VA 23235
Obstetrics & Gynecology (Maternal & Fetal Medicine)
9000 STONY POINT PKWY
RICHMOND, VA 23235
Internal Medicine (Cardiovascular Disease)
9000 STONY POINT PKWY
RICHMOND, VA 23235
Specialist/Technologist (Athletic Trainer)
9000 STONY POINT PKWY, PHYSICAL THERAPY DEPT.
RICHMOND, VA 23235
Nurse Practitioner (Family)
9000 STONY POINT PKWY
RICHMOND, VA 23235
Nurse Practitioner (Women's Health)
9000 STONY POINT PKWY
RICHMOND, VA 23235
Genetic Counselor, MS
9000 STONY POINT PKWY
RICHMOND, VA 23235

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 Luke Balmer's NPI number?

The NPI number for Luke Balmer is 1366067373. It was assigned to this individual provider in the NPPES registry on June 15, 2020.

Where is Luke Balmer located?

Luke Balmer practices at 9000 Stony Point Pkwy, Richmond, VA 23235. The listed phone number is (804) 828-2161.

What is Luke Balmer's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Luke Balmer enrolled in Medicare?

Yes. Luke Balmer 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.

Is Luke Balmer affiliated with any hospitals?

According to CMS data, Luke Balmer is affiliated with Medical College Of Virginia Hospitals and Vcu Health Tappahannock Hospital.

When was this NPI record last updated?

The NPPES record for Luke Balmer was last updated on December 30, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.