DR. ERNESTO E BANALAGAY M.D.
NPI 1629135470
Internal Medicine - Nephrology in Portsmouth, OH

Q: What is Ernesto Banalagay's NPI number?

The NPI number for Ernesto Banalagay is 1629135470. It was assigned to this individual provider in the NPPES registry on January 2, 2007.

Q: What is Ernesto Banalagay's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Ernesto Banalagay was last updated on December 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 02, 2007PECOS EnrolledAccepts Medicare Assignment

94.67/100

CMS Quality Rating

1711 27TH ST, BRAUNLIN BLDG STE 301, PORTSMOUTH, OH 45662(740) 356-5393(740) 356-7804 Get Directions Write a Review

NPPES record last updated: December 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Ernesto E Banalagay M.d. NPPES

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

DR. ERNESTO E BANALAGAY M.D. (NPI 1629135470) is an individual nephrology provider in Portsmouth, Ohio, licensed in Ohio (35073970) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Southern Ohio Medical Center, and is a graduate of Other (1981).

NPPES Registry Identity

NPI1629135470

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. ERNESTO E BANALAGAYCredential: M.D.

Location Address1711 27TH ST, BRAUNLIN BLDG STE 301Portsmouth, OH 45662-2638

Mailing Address1735 27th St Ste B06Portsmouth, OH 45662-2681 · (740) 356-8681 · Fax (740) 356-1256

Phone(740) 356-5393

Fax(740) 356-7804

Sole ProprietorNo

Medical School CMSOtherGraduated 1981

Enumeration DateJanuary 2, 2007

Last NPPES UpdateDecember 16, 2024

NPPES CertifiedDecember 16, 2024

✔ NPI 1629135470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in OH · 35073970

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1711 27TH ST, Portsmouth, OH 45662

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Other Identifiers 1

Medicaid2062995OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual 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. Ernesto E Banalagay M.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 ID9931120094

PECOS Enrollment IDI20120215000935

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 14

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.

361 services139 patients

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.

271 services153 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.

118 services96 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

109 services27 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

95 services32 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

93 services29 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

71 services56 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

70 services37 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.

62 services60 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

59 services56 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

31 services31 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

31 services23 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

24 services24 patients

Manual urinalysis test with examination using microscope, non-automated 81000

A manual urinalysis test involves studying a urine sample under a microscope. This non-automated method helps identify any abnormal substances present. It's a useful tool for detecting potential health concerns early. The process is simple and non-invasive.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Southern Ohio Medical Center

Acute Care Hospitals · Portsmouth, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360008

Location1805 27th StreetPortsmouth, OH 45662 · Scioto County

Emergency services Birthing friendly

Adams County Regional Medical Center

Critical Access Hospitals · Seaman, OH

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number361326

Location230 Medical Center DriveSeaman, OH 45679 · Adams County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45662 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

94.67/100

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

Individually scored

Quality

Improvement Activities

Cost

72.01

Reported Quality Measures

Breast Cancer Screening

0%138 patients1/55-star benchmark: 93%

Cervical Cancer Screening

0%59 patients1/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

9%34 patients1/55-star benchmark: 87%

Controlling High Blood Pressure

65%383 patients3/55-star benchmark: 91%

Diabetes: Eye Exam

0%181 patients1/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

100%181 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

56%1,942 patients2/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%441 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

14%589 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

0%489 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

29%306 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 0% · 421 patients

0%421 patients

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

85%295 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 456 patients

Patients totalRate: 0% · 456 patients

0%456 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 11

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

LYNSEY AREY NP

Nurse Practitioner

1711 27TH ST, BRAUNLIN BUILDING SUITE 306
PORTSMOUTH, OH 45662

Scioto County (740) 353-8661

MR. JEFFERY KEITH BOBO II MMSC, PA-C

Physician Assistant

1711 27TH ST
PORTSMOUTH, OH 45662

Scioto County (740) 356-1709

CHRISTINE WILLIAMS

Nurse Practitioner (Family)

1711 27TH ST
PORTSMOUTH, OH 45662

Scioto County (740) 352-1175

THOMAS LUTFALLAH KHOURY M.D.

Surgery

1711 27TH ST, BRAUNLIN BLDG, SUITE 306
PORTSMOUTH, OH 45662

Scioto County (740) 353-8661

SOUTHERN OHIO SURGICAL ASSOCIATES, INC.

Surgery

1711 27TH ST, BRAUNLIN BLDG, SUITE 306
PORTSMOUTH, OH 45662

Scioto County (740) 353-8661

RICARDO E OROZCO SA-C

Specialist/Technologist, Other (Surgical Assistant)

1711 27TH ST, BRAUNLIN BLDG, SUITE 206
PORTSMOUTH, OH 45662

Scioto County (740) 356-8239

MR. JONATHAN DAVID CRIST SA-C

Specialist/Technologist, Other (Surgical Assistant)

1711 27TH ST, BRAUNLIN BUILDING, SUITE 206
PORTSMOUTH, OH 45662

Scioto County (740) 356-6395

KRISTIE J THACKER M.S., CCC-A

Audiologist

1711 27TH ST, BRAUNLIN BUILDING, SUITE 403
PORTSMOUTH, OH 45662

Scioto County (740) 353-7881

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 Ernesto Banalagay's NPI number?

The NPI number for Ernesto Banalagay is 1629135470. It was assigned to this individual provider in the NPPES registry on January 2, 2007.

Where is Ernesto Banalagay located?

Ernesto Banalagay practices at 1711 27th St Braunlin Bldg Ste 301, Portsmouth, OH 45662. The listed phone number is (740) 356-5393.

What is Ernesto Banalagay's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Ernesto Banalagay enrolled in Medicare?

Yes. Ernesto Banalagay 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 Ernesto Banalagay accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual and Molina Healthcare list Ernesto Banalagay 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 Ernesto Banalagay affiliated with any hospitals?

According to CMS data, Ernesto Banalagay is affiliated with Southern Ohio Medical Center and Adams County Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Ernesto Banalagay was last updated on December 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.