JOSHUA BAALWA M.D.
NPI 1720423270
Pathology - Anatomic Pathology & Clinical Pathology in Winchester, VA

Active since May 09, 2013PECOS EnrolledAccepts Medicare Assignment
1840 AMHERST ST, WINCHESTER, VA 22601(540) 536-8000 Get Directions Write a Review

NPPES record last updated: May 1, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 1, 2024, Mar 9, 2023, Aug 14, 2019 and 1 more (4 updates tracked since 2017).

About Joshua Baalwa M.d. NPPES

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

JOSHUA BAALWA M.D. (NPI 1720423270) is an individual anatomic pathology & clinical pathology provider in Winchester, Virginia, licensed in Virginia (0101281492) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS, is affiliated with Winchester Medical Center, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1720423270
Entity TypeIndividualMale
Primary Taxonomy207ZP0102X
Provider Legal NameJOSHUA BAALWACredential: M.D.
Location Address1840 AMHERST STWinchester, VA 22601-2808
Mailing Address5301 Virginia Way Ste 300Brentwood, TN 37027-7542 · (615) 221-4400
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateMay 9, 2013
Last NPPES UpdateMay 1, 20244 updates tracked since enumeration
NPPES CertifiedMay 1, 2024
NPI 1720423270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Licenses Licensed in VA · 0101281492 Licensed in TX · 46771
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
Also ListedPathology · Anatomic PathologyTaxonomy 207ZP0101X · License 45503 (AL)
1840 AMHERST ST, Winchester, VA 22601

Accepted 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

Joshua Baalwa 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 ID5698000529
PECOS Enrollment IDI20240515004399, I20241017003031
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 19

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.

Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
1,356 services716 patients
Special stained specimen slides to examine tissue, each additional procedure 88341
Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.
1,146 services225 patients
Special stained specimen slides to examine tissue, initial procedure 88342
This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.
395 services327 patients
Pathology examination of tissue using a microscope, moderately high complexity 88307
A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.
125 services86 patients
Microscopic genetic analysis of tumor, manual 88360
Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.
97 services71 patients
Pathology examination of tissue using a microscope, moderately low complexity 88304
A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.
95 services84 patients

Hospital Affiliations CMS Care Compare 5

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

Winchester Medical Center

Acute Care Hospitals · Winchester, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490005
Location1840 Amherst StWinchester, VA 22601 · Winchester City County
Emergency services Birthing friendly

Warren Memorial Hospital

Acute Care Hospitals · Front Royal, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490033
Location351 Valley Health WayFront Royal, VA 22630 · Warren County
Emergency services

Shenandoah Memorial Hospital

Critical Access Hospitals · Woodstock, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number491305
Location759 South Main StreetWoodstock, VA 22664 · Shenandoah County
Emergency services

Valley Health War Memorial Hospital

Critical Access Hospitals · Berkeley Springs, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511309
Location1 Healthy WayBerkeley Springs, WV 25411 · Morgan County
Emergency services

Hampshire Memorial Hospital

Critical Access Hospitals · Romney, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511311
Location363 Sunrise BoulevardRomney, WV 26757 · Hampshire County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22601 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

Other Providers at the Same Location NPPES 20

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

Surgery (Surgical Critical Care)
1840 AMHERST ST
WINCHESTER, VA 22601
Emergency Medicine
1840 AMHERST ST
WINCHESTER, VA 22601
Emergency Medicine
1840 AMHERST ST
WINCHESTER, VA 22601
Physician Assistant
1840 AMHERST ST
WINCHESTER, VA 22601
Specialist/Technologist, Other (Surgical Assistant)
1840 AMHERST ST
WINCHESTER, VA 22601
Nurse Anesthetist, Certified Registered
1840 AMHERST ST
WINCHESTER, VA 22601
Social Worker (Clinical)
1840 AMHERST ST
WINCHESTER, VA 22601
Internal Medicine (Critical Care Medicine)
1840 AMHERST ST
WINCHESTER, VA 22601

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 Joshua Baalwa's NPI number?

The NPI number for Joshua Baalwa is 1720423270. It was assigned to this individual provider in the NPPES registry on May 9, 2013.

Where is Joshua Baalwa located?

Joshua Baalwa practices at 1840 Amherst St, Winchester, VA 22601. The listed phone number is (540) 536-8000.

What is Joshua Baalwa's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Joshua Baalwa enrolled in Medicare?

Yes. Joshua Baalwa 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 Joshua Baalwa accept?

Health plans from Blue Cross and Blue Shield of Texas list Joshua Baalwa 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 Joshua Baalwa affiliated with any hospitals?

According to CMS data, Joshua Baalwa is affiliated with Winchester Medical Center, Warren Memorial Hospital, Shenandoah Memorial Hospital, Valley Health War Memorial Hospital and Hampshire Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Joshua Baalwa was last updated on May 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.