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PRIYADARSHINI BALASUBRAMANIAN M.D.
NPI 1457706426
Internal Medicine - Endocrinology, Diabetes & Metabolism in New Haven, CT

Active since April 27, 2016PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
20 YORK ST, NEW HAVEN, CT 06510(201) 210-9033 Get Directions Write a Review

NPPES record last updated: June 28, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Priyadarshini Balasubramanian M.d. NPPES

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

PRIYADARSHINI BALASUBRAMANIAN M.D. (NPI 1457706426) is an individual endocrinology, diabetes & metabolism provider in New Haven, Connecticut, licensed in Connecticut (0063506) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in New Haven, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1457706426
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NamePRIYADARSHINI BALASUBRAMANIANCredential: M.D.
Location Address20 YORK STNew Haven, CT 06510-3220
Mailing Address789 Howard AveNew Haven, CT 06519-1304 · (203) 785-7474
Phone(201) 210-9033
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateApril 27, 2016
Last NPPES UpdateJune 28, 2022
NPPES CertifiedJune 28, 2022
✔ NPI 1457706426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in CT · 0063506
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License 63579 (CT)
20 YORK ST, New Haven, CT 06510
Open in Google Maps ↗

Secondary Practice Location 1

Location 1789 Howard AveNew Haven, CT 06519-1304 · Phone (203) 785-7474

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Priyadarshini Balasubramanian 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 ID648514703
PECOS Enrollment IDI20220818000143
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

2

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

Mill Hill Medical Consultants Inc
Same address
Hospitalist
20 YORK ST, CB 2041
New Haven, CT 06510
  • Reassigned Medicare billing, Connecticut enrollment
  • Medicare enrollment name: Northeast Medical Group Inc
  • 1,824 clinicians in this Medicare group
NPI 1952624769 (203) 688-4741
Yale University
0.4 mi
Advanced Practice Midwife
100 CHURCH ST S STE 200, YALE SCHOOL OF NURSING
New Haven, CT 06519
  • Reassigned Medicare billing, Connecticut enrollment
  • 3,728 clinicians in this Medicare group
NPI 1124148887 (203) 737-5432

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 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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
63 services21 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.
29 services23 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.
23 services19 patients
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.
22 services20 patients
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.
15 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06510 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

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.

AUDREY P SENIOR APRN
Nurse Practitioner (Family)
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-5860
DR. YEISID F FIGUEREDO M.D.
Pediatrics (Neonatal-Perinatal Medicine)
20 YORK ST, DEPT OF NEONATOLOGY
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-2320
YALE NEW HAVEN HOSPITAL
Durable Medical Equipment & Medical Supplies (Customized Equipment)
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-2046
TAYLOR KINGSTON
Dietitian, Registered
20 YORK ST, FOOD AND NUTRITION EPB806
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-9185
DR. TRAVIS DANIEL BONTRAGER MD
Hospitalist
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-1734
TERESA JOSEPH D.O.
Internal Medicine (Nephrology)
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 737-8894
MR. BRAD ST. MARTIN MD
Obstetrics & Gynecology
20 YORK ST
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 688-4242
BERNADETTE BIMONTE-HACKETT LCSW
Social Worker (Clinical)
20 YORK ST, SOCIAL WORK EP10-635
NEW HAVEN, CT 06510
South Central Connecticut Planning Region (203) 785-5161

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 Priyadarshini Balasubramanian's NPI number?

The NPI number for Priyadarshini Balasubramanian is 1457706426. It was assigned to this individual provider in the NPPES registry on April 27, 2016.

Where is Priyadarshini Balasubramanian located?

Priyadarshini Balasubramanian practices at 20 York St, New Haven, CT 06510. The listed phone number is (201) 210-9033.

What is Priyadarshini Balasubramanian's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Priyadarshini Balasubramanian enrolled in Medicare?

Yes. Priyadarshini Balasubramanian 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.

Which organizations bill Medicare for Priyadarshini Balasubramanian's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Priyadarshini Balasubramanian reassigns Medicare benefits to 2 organizations: Mill Hill Medical Consultants Inc (New Haven, CT) and Yale University (New Haven, CT). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Priyadarshini Balasubramanian's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Priyadarshini Balasubramanian accept?

Health plans from Anthem Blue Cross and Blue Shield list Priyadarshini Balasubramanian 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 Priyadarshini Balasubramanian was last updated on June 28, 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.