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SHANTHI BALARAMAN
NPI 1558818856
Nurse Practitioner - Family in Hockessin, DE

Active since September 02, 2016PECOS Enrolled
62.02/100
CMS Quality Rating
5936 LIMESTONE RD, SUITE 202, HOCKESSIN, DE 19707(302) 239-4500(302) 489-5000 Get Directions Write a Review

NPPES record last updated: September 2, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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.

NPPES Registry Identity

NPI1558818856
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANTHI BALARAMAN
Location Address5936 LIMESTONE RD, SUITE 202Hockessin, DE 19707-8930
Mailing Address5936 Limestone Rd, Suite 202Hockessin, DE 19707-8930 · (302) 239-4500 · Fax (302) 489-5000
Phone(302) 239-4500
Fax(302) 489-5000
Sole ProprietorNo
Enumeration DateSeptember 2, 2016
✔ NPI 1558818856 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in DE · LG0000955
5936 LIMESTONE RD, Hockessin, DE 19707
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 from NH Healthy Families, Ambetter from Sunflower Health Plan 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 (PECOS)

Shanthi Balaraman is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
15 services15 patients

Physician 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.

New Patient
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
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.

62.02/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.03
Promoting Interoperability0
Improvement Activities40

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers23 claims53 services$4.73 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 17

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

ROBERT KACMARCIK
Dentist
5936 LIMESTONE RD, SUITE 201
HOCKESSIN, DE 19707
New Castle County (302) 235-7645
HOCKESSIN WALK IN MEDICAL
Clinic/Center (Urgent Care)
5936 LIMESTONE RD, STE 301B
HOCKESSIN, DE 19707
New Castle County (302) 235-8808
SAMANTHA JOLLY FNP
Nurse Practitioner (Primary Care)
5936 LIMESTONE RD
HOCKESSIN, DE 19707
New Castle County (302) 235-8008
PAUL J. MCCREADY MD
Radiology (Diagnostic Radiology)
5936 LIMESTONE RD, SUITE 301
HOCKESSIN, DE 19707
New Castle County (302) 234-5800
MRS. IMELIZA FERNANDEZ AVIGLIANO MS, PA-C
Family Medicine
5936 LIMESTONE RD, SUITE 202
HOCKESSIN, DE 19707
New Castle County (302) 239-4500
ZELIMIR KOZIC MD
Specialist
5936 LIMESTONE RD, SUITE 301
HOCKESSIN, DE 19707
New Castle County (302) 234-5800
CARLOS FLORES MD
Radiology (Diagnostic Radiology)
5936 LIMESTONE RD, SUITE 301
HOCKESSIN, DE 19707
New Castle County (302) 234-5800
ALBERTO IAIA MD
Radiology (Diagnostic Radiology)
5936 LIMESTONE RD, SUITE 301
HOCKESSIN, DE 19707
New Castle County (302) 234-5800

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 enrollment system.

What insurance does Shanthi Balaraman accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers 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.

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 9 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.