1. Home
  2. Directory
  3. Texas
  4. Plano
  5. Internal Medicine
  6. NPI Profile

GOWRI BALACHANDAR M.D.
NPI 1669435889
Internal Medicine - Gastroenterology in Plano, TX

Active since April 10, 2006PECOS EnrolledAccepts Medicare Assignment
4101 W. SPRING CREEK PKWY., SUITE 400, PLANO, TX 75024(972) 867-7070(972) 867-7878 Get Directions Write a Review

NPPES record last updated: March 12, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gowri Balachandar M.d. NPPES

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

GOWRI BALACHANDAR M.D. (NPI 1669435889) is an individual gastroenterology provider in Plano, Texas, licensed in Texas (K4363) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Medical City Plano, and is a graduate of Other (1986).

NPPES Registry Identity

NPI1669435889
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameGOWRI BALACHANDARCredential: M.D.
Location Address4101 W. SPRING CREEK PKWY., SUITE 400Plano, TX 75024-5321
Mailing Address4101 W Spring Creek Pkwy, Suite 400Plano, TX 75024-5307 · (972) 867-7070 · Fax (972) 867-7878
Phone(972) 867-7070
Fax(972) 867-7878
Sole ProprietorYes
Medical School CMSOtherGraduated 1986
Enumeration DateApril 10, 2006
Last NPPES UpdateMarch 12, 2012
✔ NPI 1669435889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in TX · K4363
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
4101 W. SPRING CREEK PKWY., Plano, TX 75024
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINH14997TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Gowri Balachandar 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 ID6709891641
PECOS Enrollment IDI20101012001246
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 11

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.
120 services94 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
85 services85 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.
68 services68 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
66 services64 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.
54 services54 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Medical City Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number450651
Location3901 W 15th StPlano, TX 75075 · Collin County
Emergency services Birthing friendly

Texas Health Presbyterian Hospital Plano

Acute Care Hospitals · Plano, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450771
Location6200 W Parker RdPlano, TX 75093 · Collin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75024 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
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
97%131 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims288 services$4.61 avg. paid by Medicare
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4153
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims4,620 services$1.09 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Gowri Balachandar's NPI number?

The NPI number for Gowri Balachandar is 1669435889. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Where is Gowri Balachandar located?

Gowri Balachandar practices at 4101 W. Spring Creek Pkwy. Suite 400, Plano, TX 75024. The listed phone number is (972) 867-7070.

What is Gowri Balachandar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Gowri Balachandar enrolled in Medicare?

Yes. Gowri Balachandar 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 Gowri Balachandar accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Gowri Balachandar 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 Gowri Balachandar affiliated with any hospitals?

According to CMS data, Gowri Balachandar is affiliated with Medical City Plano and Texas Health Presbyterian Hospital Plano.

When was this NPI record last updated?

The NPPES record for Gowri Balachandar was last updated on March 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.