DR. RAJ BALLAL M.D.
NPI 1386645638
Internal Medicine - Cardiovascular Disease in Edison, NJ
About Dr. Raj Ballal M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RAJ BALLAL M.D. (NPI 1386645638) is an individual cardiovascular disease provider in Edison, New Jersey, licensed in New Jersey (MA65996) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and is a graduate of Other (1982).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Raj Ballal 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.
Medicare Billing Reassignments
4Medicare enrollment records show Raj Ballal reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Edison, NJ 08820
- Reassigned Medicare billing, New Jersey enrollment
- 165 clinicians in this Medicare group
Edison, NJ 08820
- Reassigned Medicare billing, New Jersey enrollment
- 164 clinicians in this Medicare group
Red Bank, NJ 07701
- Reassigned Medicare billing, New Jersey enrollment
- 689 clinicians in this Medicare group
Red Bank, NJ 07701
- Reassigned Medicare billing, New Jersey enrollment
- 2,844 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 11
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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hackensack University Medical Center
Acute Care Hospitals · Hackensack, NJRobert Wood Johnson University Hospital
Acute Care Hospitals · New Brunswick, NJJfk Medical Center
Acute Care Hospitals · Edison, NJPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 08820 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
EDISON, NJ 08820
EDISON, NJ 08820
EDISON, NJ 08820
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 Raj Ballal's NPI number?
The NPI number for Raj Ballal is 1386645638. It was assigned to this individual provider in the NPPES registry on August 9, 2005.
Where is Raj Ballal located?
Raj Ballal practices at 98 James St Suite 300, Edison, NJ 08820. The listed phone number is (732) 548-2523.
What is Raj Ballal's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.
Is Raj Ballal enrolled in Medicare?
Yes. Raj Ballal 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.
Which organizations bill Medicare for Raj Ballal's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Raj Ballal reassigns Medicare benefits to 4 organizations: Community Hospital Group Inc (Edison, NJ), Hmh Hospitals Corporation (Edison, NJ), Hackensack Meridian Health Medical Group - Primary Care PC (Red Bank, NJ) and Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, NJ). Each 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 Raj Ballal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Raj Ballal accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Raj Ballal 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 Raj Ballal affiliated with any hospitals?
According to CMS data, Raj Ballal is affiliated with Hackensack University Medical Center, Robert Wood Johnson University Hospital and Jfk Medical Center.
When was this NPI record last updated?
The NPPES record for Raj Ballal was last updated on January 14, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Dr. Raj Ballal, M.D. · NPI 1386645638
Cardiovascular Disease physician in Edison, New Jersey. Individual provider, active in the CMS NPPES registry since August 9, 2005.
## Identity
- **NPI:** 1386645638 (Entity type: Individual)
- **Enumerated:** August 9, 2005
- **Primary specialty:** Internal Medicine - Cardiovascular Disease · taxonomy 207RC0000X
- **State license:** MA65996 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 98 JAMES ST, SUITE 300, Edison, NJ 08820-3902
- **Phone:** (732) 548-2523 · **Fax:** (732) 549-8827
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Community Hospital Group Inc (NPI 1225251754, Edison, NJ); Hmh Hospitals Corporation (NPI 1356016661, Edison, NJ); Hackensack Meridian Health Medical Group - Primary Care PC (NPI 1336203538, Red Bank, NJ); Hackensack Meridian Health Medical Group - Specialty Care PC (NPI 1215989249, Red Bank, NJ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1982
## Record status
- **NPPES last updated:** January 14, 2010
- **Other identifiers:** Medicare UPIN F55385 (NJ); Medicaid 7560605 (NJ); Medicare PIN 875774 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1386645638) · Data from the CMS NPPES public registry.