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DR. VIJAY BABU BALAKRISHNAN M.D., CCD.
NPI 1649434333
Internal Medicine - Endocrinology, Diabetes & Metabolism in Somers Point, NJ

Active since July 11, 2008PECOS EnrolledAccepts Medicare Assignment
18 W NEW YORK AVE, SOMERS POINT, NJ 08244(609) 365-5300(609) 365-5302 Get Directions Write a Review

NPPES record last updated: December 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Vijay Babu Balakrishnan M.d., Ccd. NPPES

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

DR. VIJAY BABU BALAKRISHNAN M.D., CCD. (NPI 1649434333) is an individual endocrinology, diabetes & metabolism provider in Somers Point, New Jersey, licensed in New Jersey (25MA09484400) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS, is affiliated with Cape Regional Medical Center Inc, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1649434333
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. VIJAY BABU BALAKRISHNANCredential: M.D., CCD.
Location Address18 W NEW YORK AVESomers Point, NJ 08244-1872
Mailing Address1 E. New York Ave, 4th Floor AdminSomers Point, NJ 08225-2136 · (609) 653-3265 · Fax (609) 926-4311
Phone(609) 365-5300
Fax(609) 365-5302
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJuly 11, 2008
Last NPPES UpdateDecember 9, 2022
NPPES CertifiedDecember 6, 2022
✔ NPI 1649434333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in NJ · 25MA09484400
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
18 W NEW YORK AVE, Somers Point, NJ 08244
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Other Identifiers 1

Medicaid0440710NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Vijay Babu Balakrishnan M.d., Ccd. 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 ID6901076439
PECOS Enrollment IDI20140822000551
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Vijay Babu Balakrishnan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Shore Memorial Hospital
0.1 mi
Hematology & Oncology
1 EAST NEW YORK AVE
Somers Point, NJ 08244
  • Reassigned Medicare billing, New Jersey enrollment
  • 38 clinicians in this Medicare group
NPI 1689795338 (609) 653-3213
Shore Specialty Consultants
0.1 mi
Multi-Specialty
649 SHORE RD
Somers Point, NJ 08244
  • Reassigned Medicare billing, New Jersey enrollment
  • 51 clinicians in this Medicare group
NPI 1962808519 (609) 653-3500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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 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.
807 services406 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
235 services104 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.
82 services82 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.
41 services35 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment 95250
This process involves a tiny sensor placed under your skin that checks your blood sugar levels in tissue fluid regularly. The sensor sends these readings to a device, allowing you to track your levels in real-time. This is provided by your healthcare provider.
30 services17 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
28 services15 patients

Hospital Affiliations CMS Care Compare 2

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

Cape Regional Medical Center Inc

Acute Care Hospitals · Cape May Court House, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310011
LocationTwo Stone Harbor BlvdCape May Court House, NJ 08210 · Cape May County
Emergency services

Shore Medical Center

Acute Care Hospitals · Somers Point, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310047
Location100 Medical Center WaySomers Point, NJ 08244 · Atlantic County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08244 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
74%489 patients3/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
43%896 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
38%796 patients2/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
89%796 patients4/55-star benchmark: 99%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%6,837 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
71%234 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%581 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
63%1,780 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
75%1,658 patients4/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
14%1,591 patients1/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
99%1,780 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
12%1,780 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
30%1,780 patients
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.

Referred Medical Equipment & Supplies CMS DME claims 5

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
42 suppliers231 claims743 services$5.98 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
31 suppliers107 claims165 services$1.03 avg. paid by Medicare
External ambulatory infusion pump, insulin E0784
DME-Other DME · category DE017N
3 suppliers17 claims17 services$306.65 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
14 suppliers425 claims428 services$190.91 avg. paid by Medicare
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system K0554
DME-Other DME · category DE017N
3 suppliers18 claims18 services$182.56 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 2

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

TIFFANY MARI RIOS RD, CDE
Dietitian, Registered
18 W NEW YORK AVE
SOMERS POINT, NJ 08244
Atlantic County (609) 365-5300
DENYSE GALLAGHER
Nurse Practitioner (Family)
18 W NEW YORK AVE
SOMERS POINT, NJ 08244
Atlantic County (609) 365-5300

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 Vijay Babu Balakrishnan's NPI number?

The NPI number for Vijay Babu Balakrishnan is 1649434333. It was assigned to this individual provider in the NPPES registry on July 11, 2008.

Where is Vijay Babu Balakrishnan located?

Vijay Babu Balakrishnan practices at 18 W New York Ave, Somers Point, NJ 08244. The listed phone number is (609) 365-5300.

What is Vijay Babu Balakrishnan's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Vijay Babu Balakrishnan enrolled in Medicare?

Yes. Vijay Babu Balakrishnan 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.

Which organizations bill Medicare for Vijay Babu Balakrishnan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Vijay Babu Balakrishnan reassigns Medicare benefits to 2 organizations: Shore Memorial Hospital (Somers Point, NJ) and Shore Specialty Consultants (Somers Point, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Vijay Babu Balakrishnan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Vijay Babu Balakrishnan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Vijay Babu Balakrishnan 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 Vijay Babu Balakrishnan affiliated with any hospitals?

According to CMS data, Vijay Babu Balakrishnan is affiliated with Cape Regional Medical Center Inc and Shore Medical Center.

When was this NPI record last updated?

The NPPES record for Vijay Babu Balakrishnan was last updated on December 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.