SHANTHI BALARAMAN
NPI 1558818856
Nurse Practitioner - Family in Hockessin, DE
About Shanthi Balaraman NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHANTHI BALARAMAN (NPI 1558818856) is an individual family provider in Hockessin, Delaware, licensed in Delaware (LG0000955) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS, is affiliated with Chester County Hospital, and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Shanthi Balaraman 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.
Medicare Billing Reassignment
Medicare enrollment records show Shanthi Balaraman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hockessin, DE 19707
- Reassigned Medicare billing, Delaware enrollment
- 4 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Chester County Hospital
Acute Care Hospitals · West Chester, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19707 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
Other Providers at the Same Location NPPES 17
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HOCKESSIN, DE 19707
HOCKESSIN, DE 19707
HOCKESSIN, DE 19707
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 Shanthi Balaraman's NPI number?
The NPI number for Shanthi Balaraman is 1558818856. It was assigned to this individual provider in the NPPES registry on September 2, 2016.
Where is Shanthi Balaraman located?
Shanthi Balaraman practices at 5936 Limestone Rd Suite 202, Hockessin, DE 19707. The listed phone number is (302) 239-4500.
What is Shanthi Balaraman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shanthi Balaraman enrolled in Medicare?
Yes. Shanthi Balaraman 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.
Which organization bills Medicare for Shanthi Balaraman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shanthi Balaraman reassigns Medicare benefits to Family Practice Of Hockessin, P.A. (Hockessin, DE). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shanthi Balaraman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shanthi Balaraman accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and AmeriHealth Caritas Next and 1 other insurer list Shanthi Balaraman 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 Shanthi Balaraman affiliated with any hospitals?
According to CMS data, Shanthi Balaraman is affiliated with Chester County Hospital.
When was this NPI record last updated?
The NPPES record for Shanthi Balaraman was last updated on September 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Shanthi Balaraman · NPI 1558818856
Family physician in Hockessin, Delaware. Individual provider, active in the CMS NPPES registry since September 2, 2016.
## Identity
- **NPI:** 1558818856 (Entity type: Individual)
- **Enumerated:** September 2, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** LG0000955 (Delaware)
- **Sole proprietor:** No
## Practice location
- **Address:** 5936 LIMESTONE RD, SUITE 202, Hockessin, DE 19707-8930
- **Phone:** (302) 239-4500 · **Fax:** (302) 489-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Family Practice Of Hockessin, P.A. (NPI 1710929161, Hockessin, DE), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** September 2, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1558818856) · Data from the CMS NPPES public registry.