DR. EMILIO H. BALIUS O.D.
NPI 1619978509
Optometrist in Coral Gables, FL

Q: What is Emilio Balius's NPI number?

The NPI number for Emilio Balius is 1619978509. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Q: What is Emilio Balius's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Emilio Balius was last updated on June 19, 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.

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment

93.58/100

CMS Quality Rating

1097 S LE JEUNE RD, CORAL GABLES, FL 33134(305) 442-2021(305) 442-1498 Get Directions Write a Review

NPPES record last updated: June 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Emilio H. Balius O.d. NPPES

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

DR. EMILIO H. BALIUS O.D. (NPI 1619978509) is an individual optometrist in Coral Gables, Florida, licensed in Florida (OP0002485) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Houston - College Of Optometry (1991).

NPPES Registry Identity

NPI1619978509

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. EMILIO H. BALIUSCredential: O.D.

Location Address1097 S LE JEUNE RDCoral Gables, FL 33134-2639

Mailing Address1097 S Le Jeune RdCoral Gables, FL 33134-2639 · (305) 442-2021 · Fax (305) 442-1498

Phone(305) 442-2021

Fax(305) 442-1498

Sole ProprietorNo

Medical School CMSUniversity Of Houston - College Of OptometryGraduated 1991

Enumeration DateAugust 2, 2005

Last NPPES UpdateJune 19, 2024

NPPES CertifiedJune 19, 2024

✔ NPI 1619978509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in FL · OP0002485

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

1097 S LE JEUNE RD, Coral Gables, FL 33134

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Other Identifiers 1

Medicaid120805400FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama 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 and accepts Medicare assignment

Dr. Emilio H. Balius O.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 ID9032194717

PECOS Enrollment IDI20040621002009

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33134 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

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$75.86 typical visit price

range $18.99 – $150.24

Typical copayment $18.96 (range $4.74 – $37.56)

Most-billed visit code 99213

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.

93.58/100

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

Scored as part of a group practice

Quality

96.41

Promoting Interoperability

Improvement Activities

Cost

67.21

Other Providers at the Same Location NPPES 13

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

DR. KATHERYN ELIZABETH CREGAN OD

Optometrist

1097 S LE JEUNE RD
MIAMI, FL 33134

Miami-Dade County (305) 442-2020

DR. AHAD DEEN

Ophthalmology

1097 S LE JEUNE RD
CORAL GABLES, FL 33134

Miami-Dade County (305) 442-2020

DR. ALBERTO J. ARAN MD

Ophthalmology

1097 S LE JEUNE RD, THIRD FLOOR
MIAMI, FL 33134

Miami-Dade County (305) 442-2021

ARAN EYE ASSOCIATES PA

Specialist

1097 S LE JEUNE RD, 3RD FLOOR
CORAL GABLES, FL 33134

Miami-Dade County (305) 442-2021

DR. SAMANTHA ELIZABETH FERNANDEZ OD

Optometrist

1097 S LE JEUNE RD
MIAMI, FL 33134

Miami-Dade County (305) 442-2020

SURGERY CENTER OF CORAL GABLES LLC

Clinic/Center (Ambulatory Surgical)

1097 S LE JEUNE RD, 2ND FLOOR
CORAL GABLES, FL 33134

Miami-Dade County (305) 461-1300

DR. NATALIE D DUIDER OD

Optometrist

1097 S LE JEUNE RD
MIAMI, FL 33134

Miami-Dade County (305) 442-2020

MR. MARCO ANTONIO FABREGA JR. M.D.

Ophthalmology

1097 S LE JEUNE RD
MIAMI, FL 33134

Miami-Dade County (305) 442-2021

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 Emilio Balius's NPI number?

The NPI number for Emilio Balius is 1619978509. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Emilio Balius located?

Emilio Balius practices at 1097 S Le Jeune Rd, Coral Gables, FL 33134. The listed phone number is (305) 442-2021.

What is Emilio Balius's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Emilio Balius enrolled in Medicare?

Yes. Emilio Balius 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.

What insurance does Emilio Balius accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 4 other insurers list Emilio Balius 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 Emilio Balius was last updated on June 19, 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.