JOSE RAFAEL BALSA GUERRERO MD
NPI 1508347725
Internal Medicine in Chicago, IL

Q: What is Jose Balsa Guerrero's NPI number?

The NPI number for Jose Balsa Guerrero is 1508347725. It was assigned to this individual provider in the NPPES registry on August 25, 2018.

Q: What is Jose Balsa Guerrero's specialty?

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

Active since August 25, 2018PECOS EnrolledAccepts Medicare Assignment

84.57/100

CMS Quality Rating

1901 W HARRISON ST, CHICAGO, IL 60612(312) 864-6000 Get Directions Write a Review

NPPES record last updated: August 25, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Jose Rafael Balsa Guerrero Md NPPES

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

JOSE RAFAEL BALSA GUERRERO MD (NPI 1508347725) is an individual internal medicine provider in Chicago, Illinois, licensed in Illinois (125073408) and active in the NPI registry since August 2018. He is enrolled in Medicare PECOS, is affiliated with John H Stroger Jr Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1508347725

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJOSE RAFAEL BALSA GUERREROCredential: MD

Location Address1901 W HARRISON STChicago, IL 60612-3714

Mailing Address1901 W Harrison StChicago, IL 60612-3714 · (312) 864-6000

Phone(312) 864-6000

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateAugust 25, 2018

✔ NPI 1508347725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 125073408

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.

1901 W HARRISON ST, Chicago, IL 60612

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Jose Rafael Balsa Guerrero Md 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 ID9537413190

PECOS Enrollment IDI20210610002010

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 3

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.

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.

71 services29 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

25 services25 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.

21 services21 patients

Hospital Affiliations CMS Care Compare

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

John H Stroger Jr Hospital

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140124

Location1901 W Harrison StChicago, IL 60612 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 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

$138.86 typical visit price

range $60.08 – $183.39

Typical copayment $34.71 (range $15.02 – $45.84)

Most-billed visit code 99204

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

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.

84.57/100

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

Scored as part of a group practice

Quality

60.25

Promoting Interoperability

100

Improvement Activities

Cost

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.

JOHANNA WEFES-POTTER

Emergency Medicine

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (847) 843-2000

ARON BERHANU GUDETTA MD

Internal Medicine

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (312) 864-6000

DR. LIGAYA VILLAFRANCA MARASIGAN M.D.

Obstetrics & Gynecology (Gynecology)

1901 W HARRISON ST
CHICAG, IL 60612

Cook County (312) 864-5901

TIN TIN THOMAS M.D.

Internal Medicine

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (312) 864-6000

COOK COUNTY

Pharmacy (Clinic Pharmacy)

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (312) 864-6189

HELEN ELIZABETH STRAUS MD

Emergency Medicine

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (312) 864-0060

MR. GLEN DERRICK TRAMMELL PA-C

Physician Assistant

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (773) 869-7488

JOHN H STROGER, JR. HOSPITAL OF COOK COUNTY

General Acute Care Hospital

1901 W HARRISON ST
CHICAGO, IL 60612

Cook County (773) 319-2085

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 Jose Balsa Guerrero's NPI number?

The NPI number for Jose Balsa Guerrero is 1508347725. It was assigned to this individual provider in the NPPES registry on August 25, 2018.

Where is Jose Balsa Guerrero located?

Jose Balsa Guerrero practices at 1901 W Harrison St, Chicago, IL 60612. The listed phone number is (312) 864-6000.

What is Jose Balsa Guerrero's specialty?

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

Is Jose Balsa Guerrero enrolled in Medicare?

Yes. Jose Balsa Guerrero 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 Jose Balsa Guerrero accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Jose Balsa Guerrero 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 Jose Balsa Guerrero affiliated with any hospitals?

According to CMS data, Jose Balsa Guerrero is affiliated with John H Stroger Jr Hospital.

When was this NPI record last updated?

The NPPES record for Jose Balsa Guerrero was last updated on August 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.