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DR. RAJ BALLAL M.D.
NPI 1386645638
Internal Medicine - Cardiovascular Disease in Edison, NJ

Active since August 09, 2005PECOS EnrolledAccepts Medicare Assignment
94.95/100
CMS Quality Rating
98 JAMES ST, SUITE 300, EDISON, NJ 08820(732) 548-2523(732) 549-8827 Get Directions Write a Review

NPPES record last updated: January 14, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1386645638
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. RAJ BALLALCredential: M.D.
Location Address98 JAMES ST, SUITE 300Edison, NJ 08820-3902
Mailing Address622 Georges Rd, Suite 303North Brunswick, NJ 08902-3377 · (732) 745-4994 · Fax (732) 745-7044
Phone(732) 548-2523
Fax(732) 549-8827
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateAugust 9, 2005
Last NPPES UpdateJanuary 14, 2010
✔ NPI 1386645638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NJ · MA65996
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
98 JAMES ST, Edison, NJ 08820
Open in Google Maps ↗

Other Identifiers 3

Medicare UPINF55385NJ
Medicaid7560605NJ
Medicare PIN875774NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

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.

PECOS PAC ID2365577061
PECOS Enrollment IDI20100319000696
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 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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
1,476 services1,058 patients
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.
949 services252 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.
145 services133 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
75 services75 patients
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist 93458
This procedure involves placing a tube into your left lower heart chamber and coronary artery. It helps doctors diagnose heart conditions by allowing them to view these areas in detail. A radiologist will review the images to ensure accurate diagnosis.
45 services45 patients
Ultrasonic guidance for blood vessel access 76937
Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.
31 services31 patients

Hospital Affiliations CMS Care Compare 5

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

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310001
Location30 Prospect AveHackensack, NJ 07601 · Bergen County
Emergency services Birthing friendly

Robert Wood Johnson University Hospital

Acute Care Hospitals · New Brunswick, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310038
LocationOne Robert Wood Johnson PlaceNew Brunswick, NJ 08901 · Middlesex County
Emergency services Birthing friendly

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310039
Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County
Emergency services Birthing friendly

Overlook Medical Center

Acute Care Hospitals · Summit, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310051
Location99 Beauvoir AvenueSummit, NJ 07901 · Union County
Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician 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.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
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.

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.

94.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.26
Promoting Interoperability100
Improvement Activities40

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.

DR. HOWARD S. COHEN M.D.
Internal Medicine (Cardiovascular Disease)
98 JAMES ST, SUITE 313
EDISON, NJ 08820
Middlesex County (732) 635-0916
RUDNITZKY & SHUGAR MDS PA
Internal Medicine
98 JAMES ST, SUITE 104
EDISON, NJ 08820
Middlesex County (732) 494-6300
DR. NICHOLAS A. PARTENOPE M.D.
Preventive Medicine (Public Health & General Preventive Medicine)
98 JAMES ST, SUITE 308, MEDIPLEX BUILDING
EDISON, NJ 08820
Middlesex County (732) 388-9709
CENTRAL JERSEY OPHTHALMOLOGY,PA
Ophthalmology
98 JAMES ST, SUITE 210
EDISON, NJ 08820
Middlesex County (732) 744-1800
MS. DIPALI SHAH PA
Physician Assistant
98 JAMES ST
EDISON, NJ 08820
Middlesex County (732) 243-9694
MOSS SURGICAL, L.L.C.
Surgery
98 JAMES ST, SUITE 202
EDISON, NJ 08820
Middlesex County (732) 548-1000
SURGICAL PRACTICES ASSOCIATES, P.A.
Surgery
98 JAMES ST, SUITE 202
EDISON, NJ 08820
Middlesex County (732) 548-1000
DR. ADAM J DUHL MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
98 JAMES ST, 4TH FL
EDISON, NJ 08820
Middlesex County (732) 321-7907

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.

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, Raritan Bay Medical Center, Overlook Medical Center 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.