HOLLY BALSBAUGH N.P.
NPI 1710082532
Nurse Practitioner - Family in Scappoose, OR
NPI Status: Active since September 14, 2006
Contact Information
51377 SW OLD PORTLAND RD STE C
SCAPPOOSE, OR
ZIP 97056
Phone: (503) 543-3181
- Individual
- Female
- Nurse Practitioner
- Family
- Accepts Insurance
- PECOS Enrolled
About HOLLY BALSBAUGH
This page provides the complete NPI Profile along with additional information for Holly Balsbaugh, a provider established in Scappoose, Oregon with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1710082532 assigned on September 2006. The practitioner's primary taxonomy code is 363LF0000X with license number 200650084NP (OR). The provider is registered as an individual and her NPI record was last updated 16 years ago.
- NPI
- 1710082532
- Provider Name
- HOLLY BALSBAUGH N.P.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 51377 SW OLD PORTLAND RD STE C SCAPPOOSE, OR 97056
- Location Phone
- (503) 543-3181
- Mailing Address
- 875 NE SIMPSON ST PORTLAND, OR 97211
- Mailing Phone
- (503) 234-3172
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 09-14-2006
- Last Update Date
- 01-14-2010
- Code Navigator
A nurse practitioner (NP) like Holly Balsbaugh is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 200650084NP
- License State
- OR
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- KP OR Bronze 6000 - EPO
- KP OR Bronze HSA 7100 - EPO
- KP OR Gold 0 - EPO
- KP OR Gold 1750 - EPO
- KP OR Silver 3000 - EPO
- KP OR Silver 4000 - EPO
- KP Oregon Standard Bronze Plan - EPO
- KP Oregon Standard Gold Plan - EPO
- KP Oregon Standard Silver Plan - EPO
- KP OR Family Dental - $100 Ded - EPO
- KP OR Family Dental - $1000 - EPO
- KP OR Family Dental - $1000/$50 Ded - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Legacy - EPO
- Gold 2300 Legacy - EPO
- Regence Standard Bronze Plan Legacy - EPO
- Regence Standard Gold Plan Legacy - EPO
- Regence Standard Silver Plan Legacy - EPO
- Silver 6500 Legacy - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Holly Balsbaugh is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE000N)
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Hemoglobin a1c level
Insertion of needle into vein for collection of blood sample
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
This service was performed 11 times for 11 patientsThis procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
This service was performed 17 times for 17 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 97056 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.82
- Minimum New Patient Price $54.96
- Maximum New Patient Price $166.64
- Average New Patient Copayment $21.2
- Minimum New Patient Copayment $13.74
- Maximum New Patient Copayment $41.66
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.16
- Minimum Established Patient Price $17.68
- Maximum Established Patient Price $136.19
- Average Established Patient Copayment $24.29
- Minimum Established Patient Copayment $4.42
- Maximum Established Patient Copayment $34.04
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710082532, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
SCAPPOOSE, OR 97056
SCAPPOOSE, OR 97056
SCAPPOOSE, OR 97056
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710082532, enumerated as an "individual" on September 14, 2006.
The provider is located at 51377 SW OLD PORTLAND RD STE C SCAPPOOSE, OR 97056 and the phone number is (503) 543-3181.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Kaiser Permanente, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.