MALA MURTHY BALAKUMAR MD
NPI 1710913009
Colon & Rectal Surgery in Garden City, NY

Active since June 25, 2006PECOS EnrolledAccepts Medicare Assignment
1100 FRANKLIN AVE, SUITE 203, GARDEN CITY, NY 11530(516) 248-2422 Get Directions Write a Review

NPPES record last updated: September 2, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mala Murthy Balakumar Md NPPES

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

MALA MURTHY BALAKUMAR MD (NPI 1710913009) is an individual colon & rectal surgery provider in Garden City, New York, licensed in New York (193074) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Mount Sinai South Nassau, and is a graduate of University Of Minnesota Medical School (1990).

NPPES Registry Identity

NPI1710913009
Entity TypeIndividualFemale
Primary Taxonomy208C00000X
Provider Legal NameMALA MURTHY BALAKUMARCredential: MD
Location Address1100 FRANKLIN AVE, SUITE 203Garden City, NY 11530-3221
Mailing Address1100 Franklin Ave, Suite 203Garden City, NY 11530-3221 · (516) 248-2422
Sole ProprietorYes
Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1990
Enumeration DateJune 25, 2006
Last NPPES UpdateSeptember 2, 2014
NPI 1710913009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License Licensed in NY · 193074
Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

1100 FRANKLIN AVE, Garden City, NY 11530

Other Identifiers 2

Medicare UPING84716NY
Medicare PIN02105PNY

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

Mala Murthy Balakumar Md 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 ID9335043942
PECOS Enrollment IDI20031208000343
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 14

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, 20-29 minutes 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.
186 services116 patients
Application of chemical to stop tissue regrowth in wound 17250
This procedure involves applying a special chemical to a wound to prevent unwanted tissue from growing back. It aids in proper healing by ensuring only healthy tissue regrows. It's a common, safe practice in wound care.
68 services38 patients
Diagnostic exam of rectum and lower large bowel using an endoscope 45300
This procedure, known as a sigmoidoscopy, involves using a thin, flexible instrument called an endoscope to examine your lower large bowel and rectum. This helps in identifying any abnormalities or issues that could affect your digestive health.
67 services67 patients
Diagnostic exam of anus using an endoscope 46600
This procedure involves using a thin, flexible instrument called an endoscope to examine the anal area. It helps detect any abnormal conditions or issues. It's a safe, routine exam performed by a healthcare professional.
57 services46 patients
Injection of hemorrhoid 46500
An injection for hemorrhoids involves administering a substance into the swollen tissue to reduce its size. It's a simple, quick procedure, performed in a doctor's office, to help alleviate discomfort and inflammation.
52 services22 patients
New patient office or other outpatient visit, 30-44 minutes 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
48 services48 patients

Hospital Affiliations CMS Care Compare

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

Mount Sinai South Nassau

Acute Care Hospitals · Oceanside, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330198
LocationOne Healthy WayOceanside, NY 11572 · Nassau County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11530 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
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
61%516 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,470 patients5/55-star benchmark: 100%
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.
84%219 patients4/55-star benchmark: 100%
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.
98%578 patients4/55-star benchmark: 100%
Patient-Centered Surgical Risk Assessment and Communication
Percentage of patients who underwent a non-emergency surgery who had their personalized risks of postoperative complications assessed by their surgical team prior to surgery using a clinical data-based, patient-specific risk calculator and who received…
5%597 patients1/55-star benchmark: 100%
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…
86%1,196 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
9%54 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
90%506 patients4/55-star benchmark: 100%
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…
79%429 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 7

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

Colon & Rectal Surgery
1100 FRANKLIN AVE, SUITE 203
GARDEN CITY, NY 11530
Specialist
1100 FRANKLIN AVE, SUITE 203
GARDEN CITY, NY 11530
Colon & Rectal Surgery
1100 FRANKLIN AVE, STE 203
GARDEN CITY, NY 11530
Audiologist
1100 FRANKLIN AVE, SUITE 300
GARDEN CITY, NY 11530
Specialist
1100 FRANKLIN AVE, SUITE 203
GARDEN CITY, NY 11530
Colon & Rectal Surgery
1100 FRANKLIN AVE, SUITE 203
GARDEN CITY, NY 11530
Colon & Rectal Surgery
1100 FRANKLIN AVE, SUITE 203
GARDEN CITY, NY 11530

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 Mala Balakumar's NPI number?

The NPI number for Mala Balakumar is 1710913009. It was assigned to this individual provider in the NPPES registry on June 25, 2006.

Where is Mala Balakumar located?

Mala Balakumar practices at 1100 Franklin Ave Suite 203, Garden City, NY 11530. The listed phone number is (516) 248-2422.

What is Mala Balakumar's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Mala Balakumar enrolled in Medicare?

Yes. Mala Balakumar 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.

Is Mala Balakumar affiliated with any hospitals?

According to CMS data, Mala Balakumar is affiliated with Mount Sinai South Nassau.

When was this NPI record last updated?

The NPPES record for Mala Balakumar was last updated on September 2, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.