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ANTHONY B BALCHUNAS PA
NPI 1710090170
Physician Assistant in Waco, TX

Active since August 17, 2006PECOS EnrolledAccepts Medicare Assignment
74.33/100
CMS Quality Rating
601 W STATE HWY 6, STE 105, WACO, TX 76710(254) 741-6113(254) 741-6629 Get Directions Write a Review

NPPES record last updated: March 16, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Anthony B Balchunas Pa NPPES

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

ANTHONY B BALCHUNAS PA (NPI 1710090170) is an individual physician assistant in Waco, Texas, licensed in Texas (PA01511) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1710090170
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameANTHONY B BALCHUNASCredential: PA
Location Address601 W STATE HWY 6, STE 105Waco, TX 76710-5575
Mailing Address601 W State Hwy 6, Ste 105Waco, TX 76710-5575 · (254) 741-6113 · Fax (254) 741-6629
Phone(254) 741-6113
Fax(254) 741-6629
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateAugust 17, 2006
Last NPPES UpdateMarch 16, 2009
✔ NPI 1710090170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA01511
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
601 W STATE HWY 6, Waco, TX 76710
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Other Identifiers 2

Medicare ID-Type Unspecified81N052TX
Medicare UPINS42903TX

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

Anthony B Balchunas Pa 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 ID4688702772
PECOS Enrollment IDI20100511000695
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 6

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.
772 services473 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
553 services30 patients
Ultrasound measurement of bladder capacity after voiding 51798
Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.
200 services194 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
200 services190 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 services38 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.
30 services30 patients

Hospital Affiliations CMS Care Compare 5

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

Ascension Providence

Acute Care Hospitals · Waco, TX
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450042
Location6901 Medical ParkwayWaco, TX 76712 · Mc Lennan County
Emergency services Birthing friendly

Parkview Regional Hospital

Acute Care Hospitals · Mexia, TX
OwnershipProprietary
CMS Certification Number450400
Location600 South Bonham StreetMexia, TX 76667 · Limestone County
Emergency services

Limestone Medical Center

Critical Access Hospitals · Groesbeck, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451303
Location701 Mcclintic DriveGroesbeck, TX 76642 · Limestone County
Emergency services

Coryell Memorial Hospital

Critical Access Hospitals · Gatesville, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451379
Location1507 W Main StreetGatesville, TX 76528 · Coryell County
Emergency services

Hamilton General Hospital

Critical Access Hospitals · Hamilton, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number451392
Location400 N Brown, Building 1Hamilton, TX 76531 · Hamilton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76710 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
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.

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.

74.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality72.69
Promoting Interoperability100
Improvement Activities40
Cost41.75

Reported Quality Measures

Advance Care Plan
37%972 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
33%2,178 patients2/55-star benchmark: 88%
Controlling High Blood Pressure
63%977 patients3/55-star benchmark: 91%
Diabetes: Eye Exam
18%391 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
36%391 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%5,868 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
30%930 patients2/55-star benchmark: 100%
HIV Screening
5%2,554 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
16%3,345 patients1/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
21%2,853 patients1/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
16%3,674 patients2/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 88% · 2,615 patients
Patients screened: 95% · 2,615 patients
48%384 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Patients combinedPopulations: 13% · 1,930 patients
Patients screened: 14% · 1,930 patients
27%26 patients
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
83%771 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 1% · 974 patients
Patients totalRate: 7% · 997 patients
7%997 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.

Other Providers at the Same Location NPPES

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

CENTRAL TEXAS UROLOGIC ASSOCIATES, P.A.
Specialist
601 W STATE HWY 6, 105
WACO, TX 76710
McLennan County (254) 741-6113

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 Anthony Balchunas's NPI number?

The NPI number for Anthony Balchunas is 1710090170. It was assigned to this individual provider in the NPPES registry on August 17, 2006.

Where is Anthony Balchunas located?

Anthony Balchunas practices at 601 W State Hwy 6 Ste 105, Waco, TX 76710. The listed phone number is (254) 741-6113.

What is Anthony Balchunas's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Anthony Balchunas enrolled in Medicare?

Yes. Anthony Balchunas 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 Anthony Balchunas 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 1 other insurer list Anthony Balchunas 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 Anthony Balchunas affiliated with any hospitals?

According to CMS data, Anthony Balchunas is affiliated with Ascension Providence, Parkview Regional Hospital, Limestone Medical Center, Coryell Memorial Hospital and Hamilton General Hospital.

When was this NPI record last updated?

The NPPES record for Anthony Balchunas was last updated on March 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.