DR. ROUMEN D BALABANOV M.D.
NPI 1508817941
Psychiatry & Neurology - Neurology in Chicago, IL

Q: What is Roumen Balabanov's NPI number?

The NPI number for Roumen Balabanov is 1508817941. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Q: What is Roumen Balabanov's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for Roumen Balabanov was last updated on December 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since May 12, 2006PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

259 E ERIE ST STE 1900, CHICAGO, IL 60611(312) 695-7950(312) 695-5747 Get Directions Write a Review

NPPES record last updated: December 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 18, 2019, Oct 10, 2016 (2 updates tracked since 2016).

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About Dr. Roumen D Balabanov M.d. NPPES

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

DR. ROUMEN D BALABANOV M.D. (NPI 1508817941) is an individual neurology provider in Chicago, Illinois, licensed in Illinois (036105349) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Palos Community Hospital, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1508817941

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameDR. ROUMEN D BALABANOVCredential: M.D.

Location Address259 E ERIE ST STE 1900Chicago, IL 60611-3246

Mailing Address259 E Erie St Ste 1900Chicago, IL 60611-3246 · (312) 695-7950 · Fax (312) 695-5747

Phone(312) 695-7950

Fax(312) 695-5747

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateMay 12, 2006

Last NPPES UpdateDecember 18, 20192 updates tracked since enumeration

✔ NPI 1508817941 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in IL · 036105349

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

259 E ERIE ST STE 1900, Chicago, IL 60611

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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

Dr. Roumen D Balabanov 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 ID446266803

PECOS Enrollment IDI20060223000050

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 8

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.

Injection, ocrelizumab, 1 mg J2350

Ocrelizumab is a medication given via injection to manage conditions like Multiple Sclerosis. It helps control symptoms by targeting specific proteins in the immune system. This service involves injecting 1 mg of Ocrelizumab.

6,000 services12 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

126 services87 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

117 services37 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

59 services46 patients

Administration of chemotherapy into vein, each additional hour 96415

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

46 services18 patients

Injection of additional new drug or substance into vein 96375

This procedure involves introducing a new medication or substance into your bloodstream via a vein. It's typically done using a small needle. The substance can help treat various conditions or assist in diagnostic procedures. It's generally safe and monitored by professionals.

39 services26 patients

Hospital Affiliations CMS Care Compare 5

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

Palos Community Hospital

Acute Care Hospitals · Palos Heights, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140062

Location12251 South 80th AvenuePalos Heights, IL 60463 · Cook County

Emergency services Birthing friendly

Northwestern Lake Forest Hospital

Acute Care Hospitals · Lake Forest, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140130

Location1000 N Westmoreland RoadLake Forest, IL 60045 · Lake County

Emergency services Birthing friendly

Northwestern Medicine Delnor Community Hospital

Acute Care Hospitals · Geneva, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140211

Location300 Randall RdGeneva, IL 60134 · Kane County

Emergency services Birthing friendly

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140242

Location25 North Winfield RoadWinfield, IL 60190 · Du Page County

Emergency services Birthing friendly

Northwestern Memorial Hospital

Acute Care Hospitals · Chicago, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140281

Location251 E Huron StChicago, IL 60611 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60611 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.

94.1/100

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

Scored through an Alternative Payment Model

Quality

82.59

Promoting Interoperability

100

Improvement Activities

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.

MORGAN V MASLAUSKI PA-C

Physician Assistant