DR. ANTHONY H BALCOM MD
NPI 1487604906
Urology - Pediatric Urology in Hales Corners, WI
NPI Status: Active since May 12, 2006
Contact Information
5250 S 108TH ST
HALES CORNERS, WI
ZIP 53130
Phone: (414) 525-2400
Fax: (414) 525-2401
- Individual
- Male
- Urology
- Pediatric Urology
- Accepts Insurance
- PECOS Enrolled
About ANTHONY BALCOM
This page provides the complete NPI Profile along with additional information for Anthony Balcom, a provider established in Hales Corners, Wisconsin with a medical specialization in Urology, focusing in pediatric urology . The healthcare provider is registered in the NPI registry with number 1487604906 assigned on May 2006. The practitioner's primary taxonomy code is 2088P0231X with license number 26912 (WI). The provider is registered as an individual and his NPI record was last updated December 2025.
- NPI
- 1487604906
- Provider Name
- DR. ANTHONY H BALCOM MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5250 S 108TH ST HALES CORNERS, WI 53130
- Location Phone
- (414) 525-2400
- Location Fax
- (414) 525-2401
- Mailing Address
- 5250 S 108TH ST HALES CORNERS, WI 53130
- Mailing Phone
- (414) 525-2400
- Mailing Fax
- (414) 525-2401
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-12-2006
- Last Update Date
- 12-23-2025
- Code Navigator
Location Map
Secondary Locations
- 9000 W Wisconsin Ave PEDIATRIC UROLOGY
Milwaukee, WI 53226
(414) 266-3794 - 9000 W Wisconsin Ave PEDIATRIC UROLOGY
Milwaukee, WI 53226
(414) 266-3794 - 4845 Alameda Ave
El Paso, TX 79905
(915) 298-5444
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Urology Pediatric Urology
- Taxonomy Code
- 2088P0231X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 26912
- License State
- WI
- Taxonomy Description
- Surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208800000X | Allopathic & Osteopathic Physicians | Urology | 26912 (WI) |
| 2 | 2088P0231X | Allopathic & Osteopathic Physicians | Urology | V8461 (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 10000 - HMO
- HMO Bronze 7500 - HMO
- HMO Catastrophic 10600 with 3 free PCP visits - HMO
- HMO Gold 2000 - HMO
- HMO Gold 2700 - HMO
- HMO HDHP Silver 5900 - HMO
- HMO Silver 6000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- POS Bronze 8500 - POS
- POS Silver 6000 - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1487604906 | MEDICAID (05) | WI | |
| 007000261M | OTHER (01) | HUMANA |
Medicare Participation & PECOS Enrollment Status
Anthony Balcom is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each (HCPCS:A4352)
1 DME suppliers used 11 Medicare Claims 2200 Services Paid
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1487604906, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 18 providers are registered at the same or a nearby location.
HALES CORNERS, WI 53130
HALES CORNERS, WI 53130
HALES CORNERS, WI 53130
HALES CORNERS, WI 53130
HALES CORNERS, WI 53130
HALES CORNERS, WI 53130
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487604906, enumerated as an "individual" on May 12, 2006.
The provider is located at 5250 S 108TH ST HALES CORNERS, WI 53130 and the phone number is (414) 525-2400.
Urology with taxonomy code 2088P0231X and a focus in Pediatric Urology.
The provider might be accepting Accepts: Aspirus Health Plan, Medicare, Medicaid and Humana. Please consult your insurance carrier or call the provider to verify.
