DR. ELSAID BALBOUL MD
NPI 1467421339
Internal Medicine in Wayne, NJ

Q: What is Elsaid Balboul's NPI number?

The NPI number for Elsaid Balboul is 1467421339. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Elsaid Balboul's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Elsaid Balboul was last updated on January 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 March 14, 2006PECOS EnrolledAccepts Medicare Assignment

508 HAMBURG TPKE, SUITE 201, WAYNE, NJ 07470(973) 942-1340(973) 942-1360 Get Directions Write a Review

NPPES record last updated: January 23, 2008. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Dr. Elsaid Balboul Md NPPES

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

DR. ELSAID BALBOUL MD (NPI 1467421339) is an individual internal medicine provider in Wayne, New Jersey, licensed in New Jersey (MA59362) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Chilton Medical Center, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1467421339

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. ELSAID BALBOULCredential: MD

Location Address508 HAMBURG TPKE, SUITE 201Wayne, NJ 07470-8482

Mailing Address508 Hamburg Tpke, Suite 201Wayne, NJ 07470-8482 · (973) 942-1340 · Fax (973) 942-1360

Phone(973) 942-1340

Fax(973) 942-1360

Sole ProprietorYes

Medical School CMSOtherGraduated 1982

Enumeration DateMarch 14, 2006

Last NPPES UpdateJanuary 23, 2008

✔ NPI 1467421339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in NJ · MA59362

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.

508 HAMBURG TPKE, Wayne, NJ 07470

Open in Google Maps ↗

Other Identifiers 3

Medicaid9056301NJ

Medicare ID-Type Unspecified485344NJ

Medicare UPING08255NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Dr. Elsaid Balboul Md 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 ID7214923580

PECOS Enrollment IDI20040422000343

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 18

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 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.

704 services103 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

692 services88 patients

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.

327 services85 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

310 services56 patients

Insertion of needle into vein (3 years or older) 36410

This procedure involves placing a small needle into a vein, typically in the arm. It's done to collect blood for testing or to deliver medication. You may feel a quick pinch, but it's usually over in seconds. It's a common, safe procedure.

227 services91 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.

169 services80 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

150 services99 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

99 services67 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

95 services90 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

89 services68 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

89 services56 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

89 services83 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

87 services69 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.

84 services84 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

82 services79 patients

Nursing facility discharge management, more than 30 minutes 99316

Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.

62 services51 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

56 services50 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.

14 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Chilton Medical Center

Acute Care Hospitals · Pompton Plains, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310017

Location97 West ParkwayPompton Plains, NJ 07444 · Morris County

Emergency services Birthing friendly

St Joseph's University Medical Center Inc

Acute Care Hospitals · Paterson, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number310019

Location703 Main StPaterson, NJ 07503 · Passaic County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07470 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

Reported Quality Measures

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

Patients 1: 100% · 360 patients

100%360 patients5/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

28%25 patients2/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

Patients 1: 42% · 322 patients

42%322 patients2/55-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.

Referred Medical Equipment & Supplies CMS DME claims 8

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

4 suppliers14 claims40 services$6.82 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

3 suppliers12 claims18 services$1.17 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers16 claims16 services$41.83 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers33 claims33 services$63.32 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$31.09 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

3 suppliers11 claims2,740 services$0.03 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 13

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

DR. JAGBIR S BENIWAL MD

Surgery (Vascular Surgery)

508 HAMBURG TPKE, SUITE 205 BENIWAL MD LLC
WAYNE, NJ 07470

Passaic County (973) 956-0800

DR. EMMANUEL AYTURK AYDIN M.D.

Internal Medicine

508 HAMBURG TPKE, SUITE 102
WAYNE, NJ 07470

Passaic County (973) 595-0096

ELSAID BALBOUL MD PA

Internal Medicine

508 HAMBURG TPKE, STE 201
WAYNE, NJ 07470

Passaic County (973) 942-1340

PULMONARY MEDICINE OF WAYNE PC

Internal Medicine (Pulmonary Disease)

508 HAMBURG TPKE, SUITE 202
WAYNE, NJ 07470

Passaic County (973) 956-1404

WAYNE PRIMARY CARE, P.A.

Internal Medicine

508 HAMBURG TPKE, SUITE102
WAYNE, NJ 07470

Passaic County (973) 595-0096

OLGA ORLOV, MD PA

Pediatrics (Adolescent Medicine)

508 HAMBURG TPKE, SUITE 107
WAYNE, NJ 07470

Passaic County (973) 942-0521

DR. OLGA ORLOV M.D.

Pediatrics (Adolescent Medicine)

508 HAMBURG TPKE, SUITE 107
WAYNE, NJ 07470

Passaic County (973) 942-0541

DR. TOMASZ ADAM GRUCZYNSKI M.D.

Pediatrics

508 HAMBURG TPKE
WAYNE, NJ 07470

Passaic County (973) 942-7800

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 Elsaid Balboul's NPI number?

The NPI number for Elsaid Balboul is 1467421339. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Where is Elsaid Balboul located?

Elsaid Balboul practices at 508 Hamburg Tpke Suite 201, Wayne, NJ 07470. The listed phone number is (973) 942-1340.

What is Elsaid Balboul's specialty?

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

Is Elsaid Balboul enrolled in Medicare?

Yes. Elsaid Balboul 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 Elsaid Balboul accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Elsaid Balboul 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 Elsaid Balboul affiliated with any hospitals?

According to CMS data, Elsaid Balboul is affiliated with Chilton Medical Center and St Joseph's University Medical Center Inc.

When was this NPI record last updated?

The NPPES record for Elsaid Balboul was last updated on January 23, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.