LUIS BALBUENA JR. MD
NPI 1649254749
Otolaryngology in Marshall, TX

Q: What is Luis Balbuena's NPI number?

The NPI number for Luis Balbuena is 1649254749. It was assigned to this individual provider in the NPPES registry on December 1, 2005.

Q: What is Luis Balbuena's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Luis Balbuena was last updated on June 30, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 December 01, 2005PECOS EnrolledAccepts Medicare Assignment

703 S WASHINGTON AVE, MARSHALL, TX 75670(903) 927-6880(903) 927-6884 Get Directions Write a Review

NPPES record last updated: June 30, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Luis Balbuena Jr. Md NPPES

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

LUIS BALBUENA JR. MD (NPI 1649254749) is an individual otolaryngology provider in Marshall, Texas, licensed in Texas (J5538) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Christus Good Shepherd Medical Center, and is a graduate of University Of Texas Medical School At San Antonio (1991).

NPPES Registry Identity

NPI1649254749

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameLUIS BALBUENA JR.Credential: MD

Location Address703 S WASHINGTON AVEMarshall, TX 75670-5337

Mailing AddressPo Box 1325Marshall, TX 75671-1325 · (903) 927-6880 · Fax (903) 927-6884

Phone(903) 927-6880

Fax(903) 927-6884

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 1991

Enumeration DateDecember 1, 2005

Last NPPES UpdateJune 30, 2011

✔ NPI 1649254749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in TX · J5538

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

703 S WASHINGTON AVE, Marshall, TX 75670

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Other Identifiers 3

Medicare ID-Type Unspecified8313K1

Medicare UPINH14714

Medicaid041854301TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, UnitedHealthcare.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

Luis Balbuena Jr. 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 ID2860497773

PECOS Enrollment IDI20100915000635

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.

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.

305 services208 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.

132 services132 patients

Test to assess middle ear function 92567

A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.

103 services101 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

97 services89 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

78 services59 patients

Comprehensive hearing and speech recognition test 92557

A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.

74 services74 patients

Test for ability to detect and repeat spoken words 92555

This procedure assesses your ability to understand and repeat spoken words. You'll listen to a series of words and then repeat them back. It helps identify any issues related to hearing or speech comprehension, crucial for effective communication.

58 services58 patients

Test for hearing various pitches using earphone 92552

This is a hearing test where earphones are worn to detect different pitch levels. Sounds of various frequencies are played, and you indicate when you hear them. This helps evaluate your hearing ability. It's safe, comfortable, and non-invasive.

55 services55 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

43 services36 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.

23 services20 patients

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

16 services16 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

13 services13 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.

13 services13 patients

Exam of the nose and throat using an endoscope 92511

An endoscopic examination of the nose and throat is a procedure where a thin, flexible tube with a light and camera attached (endoscope) is used to view these areas in detail. It helps identify any abnormalities or issues that may be causing symptoms like difficulty swallowing, persistent cough, or nasal congestion.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Christus Good Shepherd Medical Center

Acute Care Hospitals · Longview, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450032

Location700 E Marshall AveLongview, TX 75601 · Gregg County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75670 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 $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

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.

Other Providers at the Same Location NPPES 2

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

MARSHALL RURAL HEALTH CLINIC

Clinic/Center (Rural Health)

703 S WASHINGTON AVE
MARSHALL, TX 75670

Harrison County (903) 927-6140

NATALIE EMERY FNP

Nurse Practitioner

703 S WASHINGTON AVE
MARSHALL, TX 75670

Harrison County (903) 927-6880

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 Luis Balbuena's NPI number?

The NPI number for Luis Balbuena is 1649254749. It was assigned to this individual provider in the NPPES registry on December 1, 2005.

Where is Luis Balbuena located?

Luis Balbuena practices at 703 S Washington Ave, Marshall, TX 75670. The listed phone number is (903) 927-6880.

What is Luis Balbuena's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Luis Balbuena enrolled in Medicare?

Yes. Luis Balbuena 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 Luis Balbuena accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and UnitedHealthcare list Luis Balbuena 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 Luis Balbuena affiliated with any hospitals?

According to CMS data, Luis Balbuena is affiliated with Christus Good Shepherd Medical Center.

When was this NPI record last updated?

The NPPES record for Luis Balbuena was last updated on June 30, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.