CAROL ANN BALFE O.D.
NPI 1427100486
Optometrist in Canajoharie, NY

Active since January 18, 2007PECOS EnrolledAccepts Medicare Assignment
70 ERIE BLVD, CANAJOHARIE, NY 13317(518) 673-2241 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Carol Ann Balfe O.d. NPPES

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

CAROL ANN BALFE O.D. (NPI 1427100486) is an individual optometrist in Canajoharie, New York, licensed in New York (T-005534-1) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and is a graduate of New England College Of Optometry (1993).

NPPES Registry Identity

NPI1427100486
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameCAROL ANN BALFECredential: O.D.
Location Address70 ERIE BLVDCanajoharie, NY 13317-1133
Mailing Address410 White RdCanajoharie, NY 13317-3239 · (518) 673-2241
Sole ProprietorYes
Medical School CMSNew England College Of OptometryGraduated 1993
Enumeration DateJanuary 18, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1427100486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in NY · T-005534-1
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
70 ERIE BLVD, Canajoharie, NY 13317

Accepted 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

Carol Ann Balfe O.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 ID6709986441
PECOS Enrollment IDI20070711000276
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 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 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.
67 services60 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.
25 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13317 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 $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

Optometrist
70 ERIE BLVD
CANAJOHARIE, NY 13317

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 Carol Balfe's NPI number?

The NPI number for Carol Balfe is 1427100486. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Carol Balfe located?

Carol Balfe practices at 70 Erie Blvd, Canajoharie, NY 13317. The listed phone number is (518) 673-2241.

What is Carol Balfe's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Carol Balfe enrolled in Medicare?

Yes. Carol Balfe 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 Carol Balfe accept?

Health plans from Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Louisiana list Carol Balfe 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.

When was this NPI record last updated?

The NPPES record for Carol Balfe was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.