DENNIS TERRANCE BALOUGH PA-C - NPI 1508200452 - Physician Assistant in Carmichael, CA

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

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About Dennis Terrance Balough Pa-c NPPES

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

DENNIS TERRANCE BALOUGH PA-C (NPI 1508200452) is an individual surgical provider in Carmichael, California, licensed in California (PA22836) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1508200452

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameDENNIS TERRANCE BALOUGHCredential: PA-C

Location Address6403 COYLE AVE STE 170Carmichael, CA 95608-0363

Mailing Address6403 Coyle Ave Ste 170Carmichael, CA 95608-0363 · (916) 965-4000 · Fax (916) 965-4813

Phone(916) 965-4000

Fax(916) 965-4813

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateApril 22, 2013

Last NPPES UpdateJanuary 3, 2022

✔ NPI 1508200452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in CA · PA22836

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA22836 (CA)

6403 COYLE AVE STE 170, Carmichael, CA 95608

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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

Dennis Terrance Balough Pa-c 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 ID1153545041

PECOS Enrollment IDI20140616001834

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.

Other Providers at the Same Location NPPES 6

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

DR. ROBERT L CAMETO MD

Orthopaedic Surgery