ASHLEY ERIN BALAKER M.D.
NPI 1427387547
Otolaryngology in Laguna Hills, CA

Q: What is Ashley Balaker's NPI number?

The NPI number for Ashley Balaker is 1427387547. It was assigned to this individual provider in the NPPES registry on December 19, 2009. The provider is also known as Dr. Ashley Erin Starkweather M.D..

Q: What is Ashley Balaker's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Ashley Balaker was last updated on January 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 December 19, 2009PECOS EnrolledAccepts Medicare Assignment

90.31/100

CMS Quality Rating

24411 HEALTH CENTER DR STE 370, LAGUNA HILLS, CA 92653(949) 364-4361(949) 364-4495 Get Directions Write a Review

NPPES record last updated: January 29, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 29, 2019, Dec 14, 2016 (2 updates tracked since 2016).

On this page

About Ashley Erin Balaker M.d. NPPES

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

ASHLEY ERIN BALAKER M.D. (NPI 1427387547) is an individual otolaryngology provider in Laguna Hills, California, licensed in California (A108296) and active in the NPI registry since December 2009. She is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2007).

NPPES Registry Identity

NPI1427387547

Entity TypeIndividualFemale

Primary Taxonomy207Y00000X

Provider Legal NameASHLEY ERIN BALAKERCredential: M.D.

Location Address24411 HEALTH CENTER DR STE 370Laguna Hills, CA 92653-3687

Mailing Address26726 Crown Valley Pkwy Ste 200Mission Viejo, CA 92691-8003 · (949) 364-4361 · Fax (949) 364-4495

Phone(949) 364-4361

Fax(949) 364-4495

Sole ProprietorNo

Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2007

Enumeration DateDecember 19, 2009

Last NPPES UpdateJanuary 29, 20192 updates tracked since enumeration

✔ NPI 1427387547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in CA · A108296

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Also ListedOtolaryngology · Otology & NeurotologyTaxonomy 207YX0901X · License A108296 (CA)

24411 HEALTH CENTER DR STE 370, Laguna Hills, CA 92653

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Other Names 1

Former Name (1)Dr. Ashley Erin Starkweather M.d.

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

Ashley Erin Balaker 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 ID547429425

PECOS Enrollment IDI20120313000314

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 14

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.

428 services270 patients

Exam of ear using a microscope 92504

An exam of the ear using a microscope allows a detailed view of the ear structures. This non-invasive procedure helps identify issues such as infections, blockages, or ear damage. It's a safe, quick, and painless way to evaluate ear health.

324 services276 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.

281 services281 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

186 services157 patients

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268

This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.

109 services94 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

74 services65 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 services32 patients

Simple removal of skin debris and drainage of mastoid cavity 69220

This procedure involves clearing out skin debris and draining fluid from the mastoid cavity, an air-filled space in the skull behind the ear. It's done to relieve discomfort, improve hearing, and prevent complications related to ear infections or other conditions.

38 services17 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.

27 services26 patients

Ct scan of face without contrast 70486

A CT scan of the face without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your face, including bones, soft tissues, and blood vessels. It's often used to diagnose diseases, injuries, or abnormalities. No contrast dye is used in this procedure.

22 services21 patients

Ct scan of cranial cavity without contrast 70480

A CT scan of the cranial cavity without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed images of your head, specifically the brain area. This can help detect conditions like tumors, infections, or injuries. No dye (contrast) is used in this procedure.

21 services21 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

17 services17 patients

Self soft tissue graft 15769

A self soft tissue graft is a dental procedure where tissue from your own mouth is used to treat areas with gum recession. This can protect roots, reduce sensitivity, and improve gum health. It's a common, safe procedure.

15 services15 patients

Exam to assess movement of vocal cord flaps using an endoscope 31579

This procedure involves using a thin, flexible tube called an endoscope to view your vocal cords. The endoscope is gently inserted through your nose or mouth to observe the movement of your vocal cords. This helps identify any abnormalities or issues.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92653 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

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.

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.

90.31/100

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

Individually scored

Quality

80.63

Improvement Activities

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

0%391 patients

Closing the Referral Loop: Receipt of Specialist Report

34%559 patients2/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

96%4,386 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

44%3,025 patients2/55-star benchmark: 98%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 94% · 1,125 patients

Patients screened: 94% · 1,125 patients

97%59 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 1,215 patients

Patients totalRate: 0% · 1,215 patients

0%1,215 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Ashley Balaker's NPI number?

The NPI number for Ashley Balaker is 1427387547. It was assigned to this individual provider in the NPPES registry on December 19, 2009. The provider is also known as Dr. Ashley Erin Starkweather M.D..

Where is Ashley Balaker located?

Ashley Balaker practices at 24411 Health Center Dr Ste 370, Laguna Hills, CA 92653. The listed phone number is (949) 364-4361.

What is Ashley Balaker's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Ashley Balaker enrolled in Medicare?

Yes. Ashley Balaker 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.

When was this NPI record last updated?

The NPPES record for Ashley Balaker was last updated on January 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.