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RONALDO S BALBOA M.D.
NPI 1417941055
Internal Medicine in Port Huron, MI

Active since September 09, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 23D0364136 · Waiver
1201 STONE ST, STE. 5, PORT HURON, MI 48060(810) 966-9556(810) 966-4898 Get Directions Write a Review

NPPES record last updated: June 17, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ronaldo S Balboa M.d. NPPES

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

RONALDO S BALBOA M.D. (NPI 1417941055) is an individual internal medicine provider in Port Huron, Michigan, licensed in Michigan (RB028997) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through August 31, 2026, and is affiliated with Mclaren Port Huron.

NPPES Registry Identity

NPI1417941055
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameRONALDO S BALBOACredential: M.D.
Location Address1201 STONE ST, STE. 5Port Huron, MI 48060-3563
Mailing Address1201 Stone St, Ste. 5Port Huron, MI 48060-3563 · (810) 966-9556 · Fax (810) 966-4898
Phone(810) 966-9556
Fax(810) 966-4898
Sole ProprietorNo
Medical School CMSOtherGraduated 1958
Enumeration DateSeptember 9, 2005
Last NPPES UpdateJune 17, 2009
✔ NPI 1417941055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · RB028997
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1201 STONE ST, Port Huron, MI 48060
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Other Identifiers 3

Medicaid1006297MI
Medicare PIN0740374MI
Medicare UPINB45815MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community, Priority Health.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

Ronaldo S Balboa 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 ID7012826886
PECOS Enrollment IDI20090728000335
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0364136

Ronaldo Balboa MD · Port Huron, MI
Active · expires Aug 31, 2026
CLIA Number23D0364136
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRonaldo S. Balboa
Laboratory Phone(810) 985-1850
Laboratory LocationRonaldo Balboa MD1201 Stone Street Ste 5, Port Huron, MI 48060
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 7

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.
80 services28 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
19 services14 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.
17 services17 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
17 services17 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
17 services17 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
11 services11 patients

Hospital Affiliations CMS Care Compare

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

Mclaren Port Huron

Acute Care Hospitals · Port Huron, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230216
Location1221 Pine Grove AvePort Huron, MI 48060 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48060 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

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
6 suppliers12 claims36 services$6.36 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers12 claims12 services$22.66 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 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. SALWA WADUD CHOUDHURY PA-C
Physician Assistant (Medical)
1201 STONE ST, SUITE #3
PORT HURON, MI 48060
St. Clair County (810) 985-5000
MRS. ELIZABETH MAY HELMREICH ANP-BC
Nurse Practitioner (Adult Health)
1201 STONE ST, SUITE 5
PORT HURON, MI 48060
St. Clair County (810) 966-9556
RIAD R. HAJJAR MD PC
Internal Medicine
1201 STONE ST, STE 5
PORT HURON, MI 48060
St. Clair County (810) 966-9556
JASON GO
Acupuncturist
1201 STONE ST, SUITE 3
PORT HURON, MI 48060
St. Clair County (312) 622-3659
DIANE MARIE SCHUNK ACNP
Nurse Practitioner (Acute Care)
1201 STONE ST, STE 8
PORT HURON, MI 48060
St. Clair County (810) 989-0000
THANAA AL-HAMAD MD
Internal Medicine (Gastroenterology)
1201 STONE ST, SUITE 3
PORT HURON, MI 48060
St. Clair County (810) 982-8742
ERIN DIMAMBRO PA-C
Physician Assistant
1201 STONE ST, STE 5
PORT HURON, MI 48060
St. Clair County (810) 966-9556
RIAD ROBERT HAJJAR M.D.
Internal Medicine
1201 STONE ST, STE. 5
PORT HURON, MI 48060
St. Clair County (810) 966-9556

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 Ronaldo Balboa's NPI number?

The NPI number for Ronaldo Balboa is 1417941055. It was assigned to this individual provider in the NPPES registry on September 9, 2005.

Where is Ronaldo Balboa located?

Ronaldo Balboa practices at 1201 Stone St Ste. 5, Port Huron, MI 48060. The listed phone number is (810) 966-9556.

What is Ronaldo Balboa's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ronaldo Balboa enrolled in Medicare?

Yes. Ronaldo Balboa 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.

Does Ronaldo Balboa hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0364136) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ronaldo Balboa accept?

Health plans from McLaren Health Plan Community and Priority Health list Ronaldo Balboa 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 Ronaldo Balboa affiliated with any hospitals?

According to CMS data, Ronaldo Balboa is affiliated with Mclaren Port Huron.

When was this NPI record last updated?

The NPPES record for Ronaldo Balboa was last updated on June 17, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.