JONATHAN FOREST BALOG D.O.
NPI 1417214289
Family Medicine in Jacksonville, FL

Q: What is Jonathan Balog's NPI number?

The NPI number for Jonathan Balog is 1417214289. It was assigned to this individual provider in the NPPES registry on April 18, 2012.

Q: What is Jonathan Balog's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Balog was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 18, 2012PECOS EnrolledAccepts Medicare Assignment

91.62/100

CMS Quality Rating

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: October 30, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 30, 2023, Aug 30, 2023, Feb 12, 2021 and 2 more (5 updates tracked since 2015).

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About Jonathan Forest Balog D.o. NPPES

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

JONATHAN FOREST BALOG D.O. (NPI 1417214289) is an individual family medicine provider in Jacksonville, Florida, licensed in Florida (OS12395) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS, is affiliated with Mayo Clinic, and maintains a secondary practice location in Jacksonville.

NPPES Registry Identity

NPI1417214289

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJONATHAN FOREST BALOGCredential: D.O.

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address200 1st St SwRochester, MN 55905-0001 · (507) 284-2511

Phone(904) 953-2000

Sole ProprietorNo

Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 2012

Enumeration DateApril 18, 2012

Last NPPES UpdateOctober 30, 20235 updates tracked since enumeration

NPPES CertifiedOctober 30, 2023

✔ NPI 1417214289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · OS12395

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Secondary Practice Location 1

Location 1550 Durbin Pavilion Dr Ste G101Jacksonville, FL 32259-4135 · Phone (904) 770-2095 · Fax (904) 770-2086

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).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

Jonathan Forest Balog D.o. 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 ID2961648878

PECOS Enrollment IDI20150812008938

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.

Medicare Billing Reassignments

Medicare enrollment records show Jonathan Balog reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mayo Clinic Jacksonville

0.4 mi

Health Service

4500 SAN PABLO RD S
Jacksonville, FL 32224

Reassigned Medicare billing, Florida enrollment
1,828 clinicians in this Medicare group

NPI 1174143986 (904) 953-2000

Baptist Primary Care Inc

1.8 mi

Family Medicine

14011 BEACH BLVD STE 400
Jacksonville, FL 32250

Reassigned Medicare billing, Florida enrollment
569 clinicians in this Medicare group

NPI 1114251543 (904) 992-1601

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 2

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.

78 services67 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.

40 services39 patients

Hospital Affiliations CMS Care Compare

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

Mayo Clinic

Acute Care Hospitals · Jacksonville, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100151

Location4500 San Pablo RdJacksonville, FL 32224 · Duval County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32224 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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.

91.62/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

77.61

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

8 suppliers26 claims54 services$5.70 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers23 claims23 services$0.95 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

KATHERINE L WALSH PA-C/MPH

Physician Assistant