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RICHARD A BALTER MD
NPI 1689766537
Internal Medicine in Commack, NY

Active since September 29, 2006PECOS Enrolled
500 COMMACK RD UNIT 160, COMMACK, NY 11725(631) 855-1200(631) 630-6297 Get Directions Write a Review

NPPES record last updated: October 20, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Richard A Balter Md NPPES

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

RICHARD A BALTER MD (NPI 1689766537) is an individual internal medicine provider in Commack, New York, licensed in New York (139759) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689766537
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameRICHARD A BALTERCredential: MD
Location Address500 COMMACK RD UNIT 160Commack, NY 11725-5009
Mailing Address500 Commack Rd Unit 160Commack, NY 11725-5009 · (631) 855-1200 · Fax (631) 630-6297
Phone(631) 855-1200
Fax(631) 630-6297
Sole ProprietorNo
Enumeration DateSeptember 29, 2006
Last NPPES UpdateOctober 20, 2025
NPPES CertifiedOctober 20, 2025
✔ NPI 1689766537 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 139759
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.
500 COMMACK RD UNIT 160, Commack, NY 11725
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Other Identifiers 1

Medicaid00699683NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Richard A Balter Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Richard Balter reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Good Samaritan Hospital Medical Center
7.4 mi
Medical Specialty
15 PARK AVE
Bay Shore, NY 11706
  • Reassigned Medicare billing, New York enrollment
  • 395 clinicians in this Medicare group
NPI 1275820961 (631) 617-5250
Good Shepherd Hospice
9.8 mi
Hospice and Palliative Medicine
110 BI COUNTY BLVD
Farmingdale, NY 11735
  • Reassigned Medicare billing, New York enrollment
  • 23 clinicians in this Medicare group
NPI 1992131635 (631) 828-7415

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 5

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.

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
262 services235 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.
148 services88 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
114 services96 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.
66 services60 patients
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.
44 services39 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11725 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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…
3%431 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
65%89 patients4/55-star benchmark: 85%
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.
95%3,382 patients4/55-star benchmark: 99%
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%36 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.
20%459 patients1/55-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…
32%442 patients2/55-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
41%609 patients2/55-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…
100%459 patients5/55-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…
0%459 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.
20%459 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.

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.

REGINA SEYUN SONG NP
Nurse Practitioner (Adult Health)
500 COMMACK RD UNIT 160
COMMACK, NY 11725
Suffolk County (631) 855-1200
THOMAS DONATO PIGNATARO
Nurse Practitioner (Family)
500 COMMACK RD UNIT 160
COMMACK, NY 11725
Suffolk County (831) 855-1200

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 Richard Balter's NPI number?

The NPI number for Richard Balter is 1689766537. It was assigned to this individual provider in the NPPES registry on September 29, 2006.

Where is Richard Balter located?

Richard Balter practices at 500 Commack Rd Unit 160, Commack, NY 11725. The listed phone number is (631) 855-1200.

What is Richard Balter's specialty?

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

Is Richard Balter enrolled in Medicare?

Yes. Richard Balter is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Richard Balter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Balter reassigns Medicare benefits to 2 organizations: Good Samaritan Hospital Medical Center (Bay Shore, NY) and Good Shepherd Hospice (Farmingdale, NY). 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 Richard Balter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Richard Balter was last updated on October 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.