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ERICA BREEN BALFOUR PA-C, MS
NPI 1467694067
Physician Assistant - Medical in Boston, MA

Active since March 27, 2009PECOS EnrolledAccepts Medicare Assignment
736 CAMBRIDGE ST, BOSTON, MA 02135(413) 794-0000 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 25, 2022, Jan 20, 2020 (2 updates tracked since 2020).

About Erica Breen Balfour Pa-c, Ms NPPES

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

ERICA BREEN BALFOUR PA-C, MS (NPI 1467694067) is an individual medical provider in Boston, Massachusetts, licensed in Massachusetts (PA3752) and active in the NPI registry since March 2009. She is enrolled in Medicare PECOS, is affiliated with Lahey Hospital & Medical Center, Burlington, and maintains a secondary practice location in Burlington.

NPPES Registry Identity

NPI1467694067
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameERICA BREEN BALFOURCredential: PA-C, MS
Location Address736 CAMBRIDGE STBoston, MA 02135-2907
Mailing Address736 Cambridge StBoston, MA 02135-2907 · (413) 794-0000
Phone(413) 794-0000
Sole ProprietorYes
Medical School CMSOtherGraduated 2008
Enumeration DateMarch 27, 2009
Last NPPES UpdateJanuary 25, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 25, 2022
✔ NPI 1467694067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MA · PA3752
736 CAMBRIDGE ST, Boston, MA 02135
Open in Google Maps ↗

Secondary Practice Location 1

Location 141 Mall RdBurlington, MA 01805-2907 · Phone (781) 744-8000

Other Identifiers 2

Other1078374MA · National Commission On Certification Of Physician Assistants
OtherPA3752MA · Board Of Registration Of Physician Assistants

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Erica Breen Balfour Pa-c, Ms 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 ID8123246873
PECOS Enrollment IDI20140821002519
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 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.

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.
160 services123 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.
125 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.
65 services53 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
23 services23 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220171
Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County
Emergency services

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.

SOOWHAN LAH M.D.
Internal Medicine
736 CAMBRIDGE ST, INTERNAL MEDICINE RESIDENCY PROGRAM - MAILBOX #13
BOSTON, MA 02135
Suffolk County (503) 886-9722
DR. MAHENDRA CARPEN MD
Internal Medicine (Cardiovascular Disease)
736 CAMBRIDGE ST, DEPT. OF CARDIOLOGY
BRIGHTON, MA 02135
Suffolk County (617) 789-5151
MONIKA BATRA
Psychiatry & Neurology (Psychiatry)
736 CAMBRIDGE ST
BRIGHTON, MA 02135
Suffolk County (617) 789-3000
RONYA OZTURK
Student in an Organized Health Care Education/Training Program
736 CAMBRIDGE ST
BOSTON, MA 02135
Suffolk County (617) 789-3000
ALEXANDER H HU MD
Student in an Organized Health Care Education/Training Program
736 CAMBRIDGE ST
BRIGHTON, MA 02135
Suffolk County (617) 789-3000
DR. ANAS AHMED SAMBAWAH M.D
Student in an Organized Health Care Education/Training Program
736 CAMBRIDGE ST
BRIGHTON, MA 02135
Suffolk County (617) 789-2990
ORFEAS LIANGOS M.D.
Internal Medicine (Nephrology)
736 CAMBRIDGE ST, ST ELIZABETHS MED CTR
BOSTON, MA 02135
Suffolk County (617) 789-3100
LORI H ADCOCK M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
736 CAMBRIDGE ST
BRIGHTON, MA 02135
Suffolk County (617) 789-2740

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 Erica Balfour's NPI number?

The NPI number for Erica Balfour is 1467694067. It was assigned to this individual provider in the NPPES registry on March 27, 2009.

Where is Erica Balfour located?

Erica Balfour practices at 736 Cambridge St, Boston, MA 02135. The listed phone number is (413) 794-0000.

What is Erica Balfour's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Erica Balfour enrolled in Medicare?

Yes. Erica Balfour 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 Erica Balfour accept?

Health plans from Anthem Blue Cross and Blue Shield list Erica Balfour 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 Erica Balfour affiliated with any hospitals?

According to CMS data, Erica Balfour is affiliated with Lahey Hospital & Medical Center, Burlington.

When was this NPI record last updated?

The NPPES record for Erica Balfour was last updated on January 25, 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.