MARGUERITE BALASTA M.D.
NPI 1396034211
Hospitalist in Philadelphia, PA
About Marguerite Balasta M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARGUERITE BALASTA M.D. (NPI 1396034211) is an individual hospitalist provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD455086) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses 2
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
Marguerite Balasta 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
2Medicare enrollment records show Marguerite Balasta reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Philadelphia, PA 19104
- Reassigned Medicare billing, Pennsylvania enrollment
- 199 clinicians in this Medicare group
Philadelphia, PA 19104
- Reassigned Medicare billing, Pennsylvania enrollment
- 752 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 5
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.
Hospital Of Univ Of Pennsylvania
Acute Care Hospitals · Philadelphia, PAPenn Presbyterian Medical Center
Acute Care Hospitals · Philadelphia, PAPennsylvania Hospital
Acute Care Hospitals · Philadelphia, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Marguerite Balasta's NPI number?
The NPI number for Marguerite Balasta is 1396034211. It was assigned to this individual provider in the NPPES registry on March 31, 2011.
Where is Marguerite Balasta located?
Marguerite Balasta practices at 3701 Market St Ste 760, Philadelphia, PA 19104. The listed phone number is (215) 349-5200.
What is Marguerite Balasta's specialty?
The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.
Is Marguerite Balasta enrolled in Medicare?
Yes. Marguerite Balasta 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 Marguerite Balasta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marguerite Balasta reassigns Medicare benefits to 2 organizations: Trustees Of The University Of Pennsylvania (Philadelphia, PA) and University Of Penn-Medical Group (Philadelphia, PA). 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 Marguerite Balasta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Marguerite Balasta accept?
Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Marguerite Balasta 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 Marguerite Balasta affiliated with any hospitals?
According to CMS data, Marguerite Balasta is affiliated with Hospital Of Univ Of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital.
When was this NPI record last updated?
The NPPES record for Marguerite Balasta was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Marguerite Balasta, M.D. · NPI 1396034211
Hospitalist physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since March 31, 2011.
## Identity
- **NPI:** 1396034211 (Entity type: Individual)
- **Enumerated:** March 31, 2011
- **Primary specialty:** Hospitalist · taxonomy 208M00000X
- **State license:** MD455086 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3701 MARKET ST STE 760, Philadelphia, PA 19104-5508
- **Phone:** (215) 349-5200
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Trustees Of The University Of Pennsylvania (NPI 1124882949, Philadelphia, PA); University Of Penn-Medical Group (NPI 1386751089, Philadelphia, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** July 21, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1396034211) · Data from the CMS NPPES public registry.