DR. ADRIAN CLAUDIU BALICA M.D.
NPI 1720198096
Obstetrics & Gynecology in Summit, NJ

Q: What is Adrian Balica's NPI number?

The NPI number for Adrian Balica is 1720198096. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Q: What is Adrian Balica's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Adrian Balica was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since August 30, 2006PECOS EnrolledAccepts Medicare Assignment

99.32/100

CMS Quality Rating

33 OVERLOOK RD STE 409, SUMMIT, NJ 07901(908) 522-2802(908) 522-2806 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2026, Mar 8, 2023 (2 updates tracked since 2023).

On this page

About Dr. Adrian Claudiu Balica M.d. NPPES

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

DR. ADRIAN CLAUDIU BALICA M.D. (NPI 1720198096) is an individual obstetrics & gynecology provider in Summit, New Jersey, licensed in New Jersey (25MA07406700) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Overlook Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1720198096

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameDR. ADRIAN CLAUDIU BALICACredential: M.D.

Location Address33 OVERLOOK RD STE 409Summit, NJ 07901-3564

Mailing AddressPo Box 416457Boston, MA 02241-6457

Phone(908) 522-2802

Fax(908) 522-2806

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateAugust 30, 2006

Last NPPES UpdateMay 5, 20262 updates tracked since enumeration

NPPES CertifiedMay 5, 2026

✔ NPI 1720198096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in NJ · 25MA07406700

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

33 OVERLOOK RD STE 409, Summit, NJ 07901

Open in Google Maps ↗

Other Identifiers 1

Medicaid0037681NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina.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

Dr. Adrian Claudiu Balica 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 ID8921056946

PECOS Enrollment IDI20050106000548

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

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 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.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Overlook Medical Center

Acute Care Hospitals · Summit, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310051

Location99 Beauvoir AvenueSummit, NJ 07901 · Union County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07901 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$79.09 typical visit price

range $20.97 – $155.92

Typical copayment $19.77 (range $5.24 – $38.98)

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.

99.32/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

90.59

Promoting Interoperability

100

Improvement Activities

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 Adrian Balica's NPI number?

The NPI number for Adrian Balica is 1720198096. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Adrian Balica located?

Adrian Balica practices at 33 Overlook Rd Ste 409, Summit, NJ 07901. The listed phone number is (908) 522-2802.

What is Adrian Balica's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Adrian Balica enrolled in Medicare?

Yes. Adrian Balica 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 Adrian Balica accept?

Health plans from Ambetter from Absolute Total Care and Ambetter of North Carolina list Adrian Balica 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 Adrian Balica affiliated with any hospitals?

According to CMS data, Adrian Balica is affiliated with Overlook Medical Center.

When was this NPI record last updated?

The NPPES record for Adrian Balica was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.