VIDYA NANDINI BALKISHUN PA-C
NPI 1750432142
Physician Assistant in Rehoboth Beach, DE

Active since January 15, 2007PECOS EnrolledAccepts Medicare Assignment
81.63/100
CMS Quality Rating
18947 JOHN J WILLIAMS HWY UNIT 101, REHOBOTH BEACH, DE 19971(302) 645-3770(302) 645-5718 Get Directions Write a Review

NPPES record last updated: October 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 22, 2021, Dec 13, 2021 (2 updates tracked since 2021).

About Vidya Nandini Balkishun Pa-c NPPES

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

VIDYA NANDINI BALKISHUN PA-C (NPI 1750432142) is an individual physician assistant in Rehoboth Beach, Delaware, licensed in Delaware (C5-0012102) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, is affiliated with Auburn Community Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1750432142
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameVIDYA NANDINI BALKISHUNCredential: PA-C
Location Address18947 JOHN J WILLIAMS HWY UNIT 101Rehoboth Beach, DE 19971-4480
Mailing Address1915 White AveKnoxville, TN 37916-2300 · (865) 331-1720
Fax(302) 645-5718
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateJanuary 15, 2007
Last NPPES UpdateOctober 21, 20242 updates tracked since enumeration
NPPES CertifiedOctober 21, 2024
NPI 1750432142 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in DE · C5-0012102
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.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License MA051675 (PA), 4813 (TN)
18947 JOHN J WILLIAMS HWY UNIT 101, Rehoboth Beach, DE 19971

Secondary Practice Locations 2

Location 13400 Spruce St, 3 Ravdin Building, Suite FPhiladelphia, PA 19104-4206 · Phone (215) 662-3202
Location 21915 White AveKnoxville, TN 37916-2300 · Phone (865) 331-1720

Other Identifiers 1

MedicaidQ070965TN

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

Vidya Nandini Balkishun Pa-c 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 ID143222000
PECOS Enrollment IDI20221005001328
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 4

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
79 services77 patients
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.
45 services43 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
21 services17 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Auburn Community Hospital

Acute Care Hospitals · Auburn, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330235
Location17 Lansing StreetAuburn, NY 13021 · Cayuga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19971 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
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$71.19 typical visit price
range $18.36 – $141.05
Typical copayment $17.79 (range $4.59 – $35.26)
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.

81.63/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.86
Promoting Interoperability100
Improvement Activities40
Cost52.79

Other Providers at the Same Location NPPES 10

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

Nurse Practitioner
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Radiology (Radiation Oncology)
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Internal Medicine (Medical Oncology)
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Nurse Practitioner
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Nurse Practitioner
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Physician Assistant
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Nurse Practitioner (Psychiatric/Mental Health)
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971
Radiology (Radiation Oncology)
18947 JOHN J WILLIAMS HWY UNIT 101
REHOBOTH BEACH, DE 19971

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 Vidya Balkishun's NPI number?

The NPI number for Vidya Balkishun is 1750432142. It was assigned to this individual provider in the NPPES registry on January 15, 2007.

Where is Vidya Balkishun located?

Vidya Balkishun practices at 18947 John J Williams Hwy Unit 101, Rehoboth Beach, DE 19971. The listed phone number is (302) 645-3770.

What is Vidya Balkishun's specialty?

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

Is Vidya Balkishun enrolled in Medicare?

Yes. Vidya Balkishun 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 Vidya Balkishun accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan list Vidya Balkishun 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 Vidya Balkishun affiliated with any hospitals?

According to CMS data, Vidya Balkishun is affiliated with Auburn Community Hospital.

When was this NPI record last updated?

The NPPES record for Vidya Balkishun was last updated on October 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.