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MR. DONALD BALACUIT DO
NPI 1598737116
Family Medicine in Monrovia, CA

Active since February 07, 2006PECOS EnrolledAccepts Medicare Assignment
416 S MYRTLE AVE, MONROVIA, CA 91016(626) 357-3296(626) 359-5608 Get Directions Write a Review

NPPES record last updated: December 1, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 1, 2015, Nov 20, 2015 (2 updates tracked since 2015).

About Mr. Donald Balacuit Do NPPES

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

MR. DONALD BALACUIT DO (NPI 1598737116) is an individual family medicine provider in Monrovia, California, licensed in California (20A7756) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1999).

NPPES Registry Identity

NPI1598737116
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMR. DONALD BALACUITCredential: DO
Location Address416 S MYRTLE AVEMonrovia, CA 91016-2812
Mailing Address416 S Myrtle AveMonrovia, CA 91016-2812 · (626) 357-3296 · Fax (626) 359-5608
Phone(626) 357-3296
Fax(626) 359-5608
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateFebruary 7, 2006
Last NPPES UpdateDecember 1, 20152 updates tracked since enumeration
✔ NPI 1598737116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · 20A7756
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.
416 S MYRTLE AVE, Monrovia, CA 91016
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Other Identifiers 3

Medicare UPINI02315
Medicare PIN932003535MO
Medicaid207375700MO

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

Mr. Donald Balacuit Do 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 ID5193712172
PECOS Enrollment IDI20040429001617
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 6

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.
929 services62 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
320 services100 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
72 services67 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
40 services38 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
37 services30 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.
24 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91016 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

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
5 suppliers14 claims36 services$4.79 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 4

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

MYRTLE MEDICAL CENTER INC
Family Medicine
416 S MYRTLE AVE
MONROVIA, CA 91016
Los Angeles County (626) 357-3296
NORMAN P. BALACUIT DPM INC
Podiatrist
416 S MYRTLE AVE
MONROVIA, CA 91016
Los Angeles County (626) 357-7721
PROHEALTH PARTNERS A MEDICAL GROUP INC
Family Medicine
416 S MYRTLE AVE
MONROVIA, CA 91016
Los Angeles County (626) 357-3296
DR. NORMAN PAMINTUAN BALACUIT DPM
Podiatrist
416 S MYRTLE AVE
MONROVIA, CA 91016
Los Angeles County (626) 357-3296

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 Donald Balacuit's NPI number?

The NPI number for Donald Balacuit is 1598737116. It was assigned to this individual provider in the NPPES registry on February 7, 2006.

Where is Donald Balacuit located?

Donald Balacuit practices at 416 S Myrtle Ave, Monrovia, CA 91016. The listed phone number is (626) 357-3296.

What is Donald Balacuit's specialty?

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

Is Donald Balacuit enrolled in Medicare?

Yes. Donald Balacuit 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.

When was this NPI record last updated?

The NPPES record for Donald Balacuit was last updated on December 1, 2015. 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.