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DR. VANITHA BALA M.D.
NPI 1386662351
Internal Medicine - Gastroenterology in Shenandoah, TX

Active since July 18, 2006PECOS EnrolledAccepts Medicare Assignment
111 VISION PARK BLVD, STE 150, SHENANDOAH, TX 77384(936) 321-0033(936) 321-0032 Get Directions Write a Review

NPPES record last updated: December 3, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2019, Apr 27, 2018 (2 updates tracked since 2018).

About Dr. Vanitha Bala M.d. NPPES

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

DR. VANITHA BALA M.D. (NPI 1386662351) is an individual gastroenterology provider in Shenandoah, Texas, licensed in Texas (Q0405) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Memorial Hermann Hospital System, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1386662351
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameDR. VANITHA BALACredential: M.D.
Location Address111 VISION PARK BLVD, STE 150Shenandoah, TX 77384-3002
Mailing AddressPo Box 130894The Woodlands, TX 77393 · (936) 321-0033
Phone(936) 321-0033
Fax(936) 321-0032
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateJuly 18, 2006
Last NPPES UpdateDecember 3, 20192 updates tracked since enumeration
✔ NPI 1386662351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in TX · Q0405
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 055919 (GA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 0116022282 (VA)
111 VISION PARK BLVD, Shenandoah, TX 77384
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Other Identifiers 1

Medicaid345954701TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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. Vanitha Bala 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 ID6608819917
PECOS Enrollment IDI20141111000208
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 10

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.
329 services202 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.
174 services59 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.
130 services128 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.
94 services90 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
80 services80 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
61 services61 patients

Hospital Affiliations CMS Care Compare 4

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

Memorial Hermann Hospital System

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450184
Location1635 North Loop WestHouston, TX 77008 · Harris County
Emergency services Birthing friendly

Memorial Hermann Memorial City Hospital

Acute Care Hospitals · Houston, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450610
Location921 GessnerHouston, TX 77024 · Harris County
Emergency services Birthing friendly

Memorial Hermann Northeast Hospital

Acute Care Hospitals · Humble, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450684
Location18951 Memorial NorthHumble, TX 77338 · Harris County
Emergency services Birthing friendly

Houston Methodist The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670122
Location17201 Interstate 45 SouthThe Woodlands, TX 77385 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77384 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
95%138 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
73%706 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%118 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
36%502 patients2/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
54%169 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%176 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
97%502 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
15%502 patients2/55-star benchmark: 59%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

WOODLANDS ENDOSCOPY CENTR, LTD.
Clinic/Center (Endoscopy)
111 VISION PARK BLVD, SUITE 160
SHENANDOAH, TX 77384
Montgomery County (936) 321-8910
PARTNERS THERAPY AND REHABILITATION,PLLC
Clinic/Center (Physical Therapy)
111 VISION PARK BLVD, SUITE 250
SHENANDOAH, TX 77384
Montgomery County (281) 363-2829
ANNA M GONZALES M.D.
Internal Medicine (Gastroenterology)
111 VISION PARK BLVD, STE 150
SHENANDOAH, TX 77384
Montgomery County (936) 321-0033
PROF. MELISSA R MIGNOGNA PH.D.
Psychologist
111 VISION PARK BLVD, SUITE 250
SHENANDOAH, TX 77384
Montgomery County (281) 528-4226
TIMOTHY MICHEAL YORK LSA
Physician Assistant (Surgical)
111 VISION PARK BLVD, SUITE 240
SHENANDOAH, TX 77384
Montgomery County (832) 264-1953
EDWARD S XAVIER MD
Internal Medicine (Gastroenterology)
111 VISION PARK BLVD, SUITE 150
SHENANDOAH, TX 77384
Montgomery County (936) 321-0033
JAMIE RESPONDEK DOAN FNP-C
Nurse Practitioner (Family)
111 VISION PARK BLVD, SUITE 150
SHENANDOAH, TX 77384
Montgomery County (936) 321-0033
MIRZA N BAIG M.D., PH.D.
Neurological Surgery
111 VISION PARK BLVD, SUITE 220
SHENANDOAH, TX 77384
Montgomery County (855) 457-7463

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 Vanitha Bala's NPI number?

The NPI number for Vanitha Bala is 1386662351. It was assigned to this individual provider in the NPPES registry on July 18, 2006.

Where is Vanitha Bala located?

Vanitha Bala practices at 111 Vision Park Blvd Ste 150, Shenandoah, TX 77384. The listed phone number is (936) 321-0033.

What is Vanitha Bala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Vanitha Bala enrolled in Medicare?

Yes. Vanitha Bala 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 Vanitha Bala accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 5 other insurers list Vanitha Bala 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 Vanitha Bala affiliated with any hospitals?

According to CMS data, Vanitha Bala is affiliated with Memorial Hermann Hospital System, Memorial Hermann Memorial City Hospital, Memorial Hermann Northeast Hospital and Houston Methodist The Woodlands Hospital.

When was this NPI record last updated?

The NPPES record for Vanitha Bala was last updated on December 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.