1. Home
  2. Directory
  3. Pennsylvania
  4. Philadelphia
  5. Hospitalist
  6. NPI Profile

MARGUERITE BALASTA M.D.
NPI 1396034211
Hospitalist in Philadelphia, PA

Active since March 31, 2011PECOS EnrolledAccepts Medicare Assignment
3701 MARKET ST STE 760, PHILADELPHIA, PA 19104(215) 349-5200 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Aug 10, 2017 (2 updates tracked since 2017).

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

NPI1396034211
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameMARGUERITE BALASTACredential: M.D.
Location Address3701 MARKET ST STE 760Philadelphia, PA 19104-5508
Mailing Address3701 Market St, Ste 760Philadelphia, PA 19104-5502 · (215) 349-5200
Phone(215) 349-5200
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateMarch 31, 2011
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1396034211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in PA · MD455086
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 53011 (CT)
3701 MARKET ST STE 760, Philadelphia, PA 19104
Open in Google Maps ↗

Accepted Insurance

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

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.

PECOS PAC ID749409373
PECOS Enrollment IDI20150709000772
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 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.

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.
129 services107 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
46 services46 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
18 services18 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
13 services13 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
11 services11 patients

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, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390223
Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County
Emergency services

Pennsylvania Hospital

Acute Care Hospitals · Philadelphia, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390226
Location800 Spruce StreetPhiladelphia, PA 19107 · Philadelphia County
Emergency services Birthing friendly

Physician 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.

New Patient
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

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.

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.