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DR. ALFONSO G. BALLESTEROS M.D.
NPI 1497957815
Surgery in Sun City, AZ

Active since June 05, 2007PECOS EnrolledAccepts Medicare Assignment
87.81/100
CMS Quality Rating
14416 W MEEKER BLVD STE 100, SUN CITY, AZ 85375(623) 285-2780(623) 285-2728 Get Directions Write a Review

NPPES record last updated: February 22, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 22, 2023, Oct 21, 2016 (2 updates tracked since 2016).

About Dr. Alfonso G. Ballesteros M.d. NPPES

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

DR. ALFONSO G. BALLESTEROS M.D. (NPI 1497957815) is an individual surgery provider in Sun City, Arizona, licensed in Texas (N2930) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical School At San Antonio (2004).

NPPES Registry Identity

NPI1497957815
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameDR. ALFONSO G. BALLESTEROSCredential: M.D.
Location Address14416 W MEEKER BLVD STE 100Sun City, AZ 85375-5284
Mailing Address14420 W Meeker Blvd Ste 200Sun City, AZ 85375-5288
Phone(623) 285-2780
Fax(623) 285-2728
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2004
Enumeration DateJune 5, 2007
Last NPPES UpdateFebruary 22, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 22, 2023
✔ NPI 1497957815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in TX · N2930
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

14416 W MEEKER BLVD STE 100, Sun City, AZ 85375
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and more.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. Alfonso G. Ballesteros 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 ID4587717673
PECOS Enrollment IDI20150319001512
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 10

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
96 services96 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.
73 services45 patients
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.
71 services58 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.
50 services50 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.
41 services39 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
39 services39 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85375 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
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.

87.81/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities40
Cost61.22

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each A4425
DME-Orthotic Devices · category DF010N
2 suppliers13 claims440 services$3.45 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 2

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

LAUREN F SCOTT NP
Nurse Practitioner (Family)
14416 W MEEKER BLVD STE 100
SUN CITY WEST, AZ 85375
Maricopa County (623) 524-8960
DR. AARON MATTHEW GOLDFADEN M.D.
Surgery
14416 W MEEKER BLVD STE 100
SUN CITY WEST, AZ 85375
Maricopa County (623) 285-2780

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 Alfonso Ballesteros's NPI number?

The NPI number for Alfonso Ballesteros is 1497957815. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Where is Alfonso Ballesteros located?

Alfonso Ballesteros practices at 14416 W Meeker Blvd Ste 100, Sun City, AZ 85375. The listed phone number is (623) 285-2780.

What is Alfonso Ballesteros's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Alfonso Ballesteros enrolled in Medicare?

Yes. Alfonso Ballesteros 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 Alfonso Ballesteros accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Alfonso Ballesteros 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 Alfonso Ballesteros was last updated on February 22, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.