DR. VIRGINIA MARIAN BALDERSTON M.D.
NPI 1487632311
Internal Medicine in Gibsonia, PA

Q: What is Virginia Balderston's NPI number?

The NPI number for Virginia Balderston is 1487632311. It was assigned to this individual provider in the NPPES registry on December 30, 2005.

Q: What is Virginia Balderston's specialty?

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

Active since December 30, 2005PECOS EnrolledAccepts Medicare Assignment

78.53/100

CMS Quality Rating

5318 RANALLI DR, GIBSONIA, PA 15044(724) 449-9355(724) 449-2727 Get Directions Write a Review

NPPES record last updated: January 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Virginia Marian Balderston M.d. NPPES

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

DR. VIRGINIA MARIAN BALDERSTON M.D. (NPI 1487632311) is an individual internal medicine provider in Gibsonia, Pennsylvania, licensed in Pennsylvania (MD045329L) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS, is affiliated with Allegheny General Hospital, and is a graduate of University Of Pittsburgh School Of Medicine (1989).

NPPES Registry Identity

NPI1487632311

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. VIRGINIA MARIAN BALDERSTONCredential: M.D.

Location Address5318 RANALLI DRGibsonia, PA 15044-9653

Mailing Address5318 Ranalli DrGibsonia, PA 15044-9653 · (724) 449-9355 · Fax (724) 449-2727

Phone(724) 449-9355

Fax(724) 449-2727

Sole ProprietorNo

Medical School CMSUniversity Of Pittsburgh School Of MedicineGraduated 1989

Enumeration DateDecember 30, 2005

Last NPPES UpdateJanuary 23, 2023

NPPES CertifiedJanuary 23, 2023

✔ NPI 1487632311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD045329L

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.

5318 RANALLI DR, Gibsonia, PA 15044

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Other Identifiers 1

Medicaid001536060000PA

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. Virginia Marian Balderston 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 ID2365345899

PECOS Enrollment IDI20040130000714

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 9

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.

377 services188 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.

185 services117 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.

110 services110 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

51 services50 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.

30 services25 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

15 services15 patients

Hospital Affiliations CMS Care Compare 5

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

Allegheny General Hospital

Acute Care Hospitals · Pittsburgh, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390050

Location320 East North AvenuePittsburgh, PA 15212 · Allegheny County

Emergency services

Upmc St Margaret

Acute Care Hospitals · Pittsburgh, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390102

Location815 Freeport RoadPittsburgh, PA 15215 · Allegheny County

Emergency services

Upmc Passavant

Acute Care Hospitals · Pittsburgh, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390107

Location9100 Babcock BoulevardPittsburgh, PA 15237 · Allegheny County

Emergency services

Magee Womens Hospital Of Upmc Health System

Acute Care Hospitals · Pittsburgh, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390114

Location300 Halket StreetPittsburgh, PA 15213 · Allegheny County

Emergency services Birthing friendly

Ahn Wexford Hospital

Acute Care Hospitals · Wexford, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390334

Location12351 Perry HighwayWexford, PA 15090 · Allegheny County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15044 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

78.53/100

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

Scored as part of a group practice

Quality

74.61

Promoting Interoperability

100

Improvement Activities

Cost

53.82

Referred Medical Equipment & Supplies CMS DME claims 14

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

5 suppliers16 claims29 services$5.93 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

7 suppliers16 claims16 services$29.89 avg. paid by Medicare

Tracheal suction catheter, any type other than closed system, each A4624

DME-Other DME · category DE000N

1 supplier11 claims990 services$2.28 avg. paid by Medicare

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6402

DME-Medical/Surgical Supplies · category DA023N

1 supplier11 claims990 services$0.11 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

2 suppliers16 claims32 services$1.22 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers16 claims16 services$66.10 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 9

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

UPMC COMMUNITY MEDICINE, INC

Internal Medicine