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USHA BALMURI MD
NPI 1578905154
Family Medicine in Charlotte, NC

Active since July 23, 2013PECOS EnrolledAccepts Medicare Assignment
95.35/100
CMS Quality Rating
12311 COPPER WAY, STE 200, CHARLOTTE, NC 28277(704) 667-0820 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 15, 2024, May 4, 2023, Mar 9, 2023 and 47 more (50 updates tracked since 2016).

About Usha Balmuri Md NPPES

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

USHA BALMURI MD (NPI 1578905154) is an individual family medicine provider in Charlotte, North Carolina, licensed in North Carolina (2016-01747) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center/behav Health, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1578905154
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameUSHA BALMURICredential: MD
Location Address12311 COPPER WAY, STE 200Charlotte, NC 28277-3642
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Phone(704) 667-0820
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJuly 23, 2013
Last NPPES UpdateJuly 15, 202450 updates tracked since enumeration
✔ NPI 1578905154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 2016-01747
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12311 COPPER WAY, Charlotte, NC 28277
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.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

Usha Balmuri 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 ID5698063378
PECOS Enrollment IDI20161012001984
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Usha Balmuri reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Charlotte-Mecklenburg Hospital Authority
1.1 mi
Internal Medicine
15830 BALLANTYNE MEDICAL PL, STE 200
Charlotte, NC 28277
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,534 clinicians in this Medicare group
NPI 1982038683 (980) 442-9600
Carolinas Physicians Network Inc
1.3 mi
Sports Medicine
14214 BALLANTYNE LAKE RD, STE 150
Charlotte, NC 28277
  • Reassigned Medicare billing, North Carolina and South Carolina enrollments
  • Also billed through NPI 1952626376 (North Carolina), NPI 1043819535 (South Carolina)
  • 2,057 clinicians in this Medicare group
NPI 1386991297 (704) 863-4878

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 10

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
150 services81 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
42 services42 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
34 services30 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
23 services16 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
15 services15 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
15 services15 patients

Hospital Affiliations CMS Care Compare

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

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340113
Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

95.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.22
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

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
12 suppliers35 claims97 services$6.34 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers18 claims32 services$1.19 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 12

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

THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
12311 COPPER WAY, SUITE 200-A
CHARLOTTE, NC 28277
Mecklenburg County (704) 403-2660
DR. AMIT MAHESH PATEL M.D.
Internal Medicine (Rheumatology)
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 316-2916
DR. STEVEN ROBERT BAUER
Family Medicine
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 540-1640
BALLANTYNE MEDICAL ASSOCIATES PLLC
Non-Pharmacy Dispensing Site
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 540-1640
BALLANTYNE MEDICAL ASSOCIATES PLLC
Family Medicine
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 540-1640
SALLY E HARRILL PT
Physical Therapist
12311 COPPER WAY, SUITE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 541-8788
CAROLINA ANALGESIC INC
Durable Medical Equipment & Medical Supplies
12311 COPPER WAY, SUITE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 644-1508
MIRA SANJAY PATEL PA-C
Physician Assistant
12311 COPPER WAY
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-0820

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 Usha Balmuri's NPI number?

The NPI number for Usha Balmuri is 1578905154. It was assigned to this individual provider in the NPPES registry on July 23, 2013.

Where is Usha Balmuri located?

Usha Balmuri practices at 12311 Copper Way Ste 200, Charlotte, NC 28277. The listed phone number is (704) 667-0820.

What is Usha Balmuri's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Usha Balmuri enrolled in Medicare?

Yes. Usha Balmuri 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 organizations bill Medicare for Usha Balmuri's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Usha Balmuri reassigns Medicare benefits to 2 organizations: The Charlotte-Mecklenburg Hospital Authority (Charlotte, NC) and Carolinas Physicians Network Inc (Charlotte, NC). Each 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 Usha Balmuri's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Usha Balmuri accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 2 other insurers list Usha Balmuri 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 Usha Balmuri affiliated with any hospitals?

According to CMS data, Usha Balmuri is affiliated with Carolinas Medical Center/Behav Health.

When was this NPI record last updated?

The NPPES record for Usha Balmuri was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.