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OCTAVIA BALAN MD
NPI 1649236134
Internal Medicine in Buffalo, NY

Active since April 24, 2006PECOS EnrolledAccepts Medicare Assignment
87.14/100
CMS Quality Rating
85 HIGH ST, BUFFALO, NY 14203(716) 630-1000(716) 630-1254 Get Directions Write a Review

NPPES record last updated: December 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2021, Oct 23, 2019, Jun 21, 2016 (3 updates tracked since 2016).

About Octavia Balan Md NPPES

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

OCTAVIA BALAN MD (NPI 1649236134) is an individual internal medicine provider in Buffalo, New York, licensed in New York (238626) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Sisters Of Charity Hospital, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1649236134
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameOCTAVIA BALANCredential: MD
Location Address85 HIGH STBuffalo, NY 14203-1149
Mailing Address425 Essjay Rd Ste 170Williamsville, NY 14221-8235 · (716) 630-1219 · Fax (716) 817-1726
Phone(716) 630-1000
Fax(716) 630-1254
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateApril 24, 2006
Last NPPES UpdateDecember 2, 20213 updates tracked since enumeration
NPPES CertifiedDecember 2, 2021
✔ NPI 1649236134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 238626
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License 238626 (NY)
85 HIGH ST, Buffalo, NY 14203
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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

Octavia Balan 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 ID9234140534
PECOS Enrollment IDI20060530000204
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 9

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 nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
202 services71 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
173 services56 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.
155 services66 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
65 services26 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
47 services21 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
43 services42 patients

Hospital Affiliations CMS Care Compare

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

Sisters Of Charity Hospital

Acute Care Hospitals · Buffalo, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330078
Location2157 Main StreetBuffalo, NY 14214 · Erie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14203 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

87.14/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.29
Promoting Interoperability100
Improvement Activities40
Cost74.86

Other Providers at the Same Location NPPES 20

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

ERIN B MIDDLER P.A.
Physician Assistant
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 862-1969
AKHIL MOGALAPALLI
Internal Medicine
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 630-1000
DR. ALEC G MILLER MD
Internal Medicine
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 630-1000
BETHANY MCCLINSEY PA
Physician Assistant (Medical)
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 857-8607
RACHEL ELIZABETH HORVATH PA-C
Physician Assistant
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 630-1000
DR. JORDAN CINQUINO D.O
Internal Medicine
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 630-1000
DR. JEFFREY JOHN LACH DO
Hospitalist
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 630-1000
MR. VICTOR LEE SANDERS MD
Hospitalist
85 HIGH ST
BUFFALO, NY 14203
Erie County (716) 630-1000

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 Octavia Balan's NPI number?

The NPI number for Octavia Balan is 1649236134. It was assigned to this individual provider in the NPPES registry on April 24, 2006.

Where is Octavia Balan located?

Octavia Balan practices at 85 High St, Buffalo, NY 14203. The listed phone number is (716) 630-1000.

What is Octavia Balan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Octavia Balan enrolled in Medicare?

Yes. Octavia Balan 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.

Is Octavia Balan affiliated with any hospitals?

According to CMS data, Octavia Balan is affiliated with Sisters Of Charity Hospital.

When was this NPI record last updated?

The NPPES record for Octavia Balan was last updated on December 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.