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BALBOA NEPHROLOGY MED GRP INC
NPI 1750569489
Internal Medicine - Nephrology in El Centro, CA

Active since February 05, 2008CLIA 05D0707199 · Waiver
2205 ROSS AVE, SUITE 101, EL CENTRO, CA 92243(760) 353-0404(760) 353-0392 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 16, 2026, Feb 8, 2021 (2 updates tracked since 2021).

About Balboa Nephrology Med Grp Inc NPPES

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

BALBOA NEPHROLOGY MED GRP INC (NPI 1750569489) is a healthcare organization registered as a nephrology in El Centro, California and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through December 22, 2027 and lists Stephanie Wenceslao, Contracts & Credentialing, as its authorized official.

NPPES Registry Identity

NPI1750569489
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameBALBOA NEPHROLOGY MED GRP INC
Location Address2205 ROSS AVE, SUITE 101El Centro, CA 92243-3623
Mailing Address9373 Hazard Way Ste 200San Diego, CA 92123-1226 · (858) 810-8000 · Fax (858) 268-1911
Phone(760) 353-0404
Fax(760) 353-0392
Organization SubpartNo
Authorized OfficialStephanie WenceslaoContracts & Credentialing · (858) 810-8000
Enumeration DateFebruary 5, 2008
Last NPPES UpdateJanuary 16, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2026
✔ NPI 1750569489 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
2205 ROSS AVE, El Centro, CA 92243
Open in Google Maps ↗

Other Identifiers 1

MedicaidGR0103520CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Balboa Nephrology Med Grp Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

85

Medicare enrollment records show 85 clinicians reassign Medicare billing to Balboa Nephrology Med Grp Inc, which bills Medicare for the services they deliver. Of these, 4 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Nephrology57
Nurse Practitioner20
General Surgery3
Clinical Social Worker2
Cardiovascular Disease (Cardiology)1
Registered Dietitian or Nutrition Professional1
Vascular Surgery1

Nearest to this location (20)

See all 85
Ramin Berenji, M.D.
Nephrology
NPI 1063497691
2205 ROSS AVE STE 101
El Centro, CA 92243
(760) 353-0404
✔ PECOS✔ Accepts MedicareSame address
Maria Jose Herrera, FNP-C
Nurse Practitioner
NPI 1992422703
2205 ROSS AVE STE 101
El Centro, CA 92243
(760) 353-0404
✔ PECOS✔ Accepts MedicareSame address
Shahid Hussain, M.D.
Nephrology
NPI 1063497220
2205 ROSS AVE STE 101
El Centro, CA 92243
(760) 353-0404
✔ PECOS✔ Accepts MedicareSame address
Irmaris Quinones, MD
Nephrology
NPI 1598326522
2205 ROSS AVE STE 101
El Centro, CA 92243
(760) 353-0404
✔ PECOS✔ Accepts MedicareSame address
Joe Gonzales, FNP
Nurse Practitioner
NPI 1558908368
207 W LEGION RD
Brawley, CA 92227
(760) 351-3333
✔ PECOS✔ Accepts Medicare12 mi
Dimitri Sherev, M.D.
Cardiovascular Disease (Cardiology)
NPI 1154323996
1380 EL CAJON BLVD STE 100
El Cajon, CA 92020
(619) 867-0557
✔ PECOS✔ Accepts Medicare82 mi
Adriana Misuraca, LCSW
Clinical Social Worker
NPI 1568976199
8851 CENTER DR STE 505
La Mesa, CA 91942
(858) 810-8000
✔ PECOS✔ Accepts Medicare83 mi
Savannah Tadin, ARNP
Nurse Practitioner
NPI 1093175994
8851 CENTER DR STE 505
La Mesa, CA 91942
(858) 810-8000
✔ PECOS83 mi
Luan Do, M.D.
Nephrology
NPI 1538156245
8851 CENTER DR SUITE 505
La Mesa, CA 91942
(619) 461-3880
✔ PECOS✔ Accepts Medicare83 mi
George Fadda, M.D.
Nephrology
NPI 1619972247
8851 CENTER DR STE 505
La Mesa, CA 91942
(619) 461-3880
✔ PECOS✔ Accepts Medicare83 mi
Lynn Hoerres, FNP-C
Nurse Practitioner
NPI 1689226508
8851 CENTER DR STE 505
La Mesa, CA 91942
(619) 461-3880
✔ PECOS✔ Accepts Medicare83 mi
Jonathan Lahuynh, APRN
Nurse Practitioner
NPI 1063188670
8851 CENTER DR STE 505
La Mesa, CA 91942
(619) 461-3880
✔ PECOS✔ Accepts Medicare83 mi
Daniel Leininger, D.O.
Nephrology
NPI 1164956264
8851 CENTER DR STE 505
La Mesa, CA 91942
(619) 461-3880
✔ PECOS✔ Accepts Medicare83 mi
Lucy Miller, M.D.
Nephrology
NPI 1467458620
8851 CENTER DR STE 505
La Mesa, CA 91942
(619) 461-3880
✔ PECOS✔ Accepts Medicare83 mi
Alexander Salloum, MD
Vascular Surgery
NPI 1124176151
1111 BROADWAY STE 305
Chula Vista, CA 91911
(619) 567-7007
✔ PECOS✔ Accepts Medicare88 mi
Melanie Braytenbah, NP-C
Nurse Practitioner
NPI 1508370875
416 BROADWAY
Chula Vista, CA 91910
(619) 427-1144
✔ PECOS✔ Accepts Medicare89 mi
Meenakshi Krishnamurthy, MS, RD
Registered Dietitian or Nutrition Professional
NPI 1790304822
416 BROADWAY
Chula Vista, CA 91910
(619) 427-1144
✔ Accepts Medicare89 mi
Jeffrey Halldorson, M.D.
General Surgery
NPI 1558446351
8010 FROST ST STE 100
San Diego, CA 92123
(858) 637-4700
✔ PECOS✔ Accepts Medicare91 mi
Marquis Hart, M.D.
General Surgery
NPI 1356401442
8010 FROST ST STE 100
San Diego, CA 92123
(858) 637-4700
✔ PECOS✔ Accepts Medicare91 mi
Emily Kerby
General Surgery
NPI 1851897607
8010 FROST ST STE 100
San Diego, CA 92123
(858) 637-4700
✔ PECOS✔ Accepts Medicare91 mi
See all 85 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0707199

Balboa Nephrology Medical Group, Inc · El Centro, CA
Active · expires Dec 22, 2027
CLIA Number05D0707199
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorDr. Ramin Berenji
Laboratory Phone(760) 353-0404
Laboratory LocationBalboa Nephrology Medical Group, Inc2205 W Ross Ave Ste 101, El Centro, CA 92243
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Balboa Nephrology Med Grp Inc's NPI number?

The NPI number for Balboa Nephrology Med Grp Inc is 1750569489. It was assigned to this organization in the NPPES registry on February 5, 2008.

Where is Balboa Nephrology Med Grp Inc located?

Balboa Nephrology Med Grp Inc is located at 2205 Ross Ave Suite 101, El Centro, CA 92243. The listed phone number is (760) 353-0404.

What is Balboa Nephrology Med Grp Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Balboa Nephrology Med Grp Inc enrolled in Medicare?

Yes. Balboa Nephrology Med Grp Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Balboa Nephrology Med Grp Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 85 clinicians in 7 Medicare specialties reassign their Medicare billing to Balboa Nephrology Med Grp Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nephrology (57), Nurse Practitioner (20) and General Surgery (3). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Balboa Nephrology Med Grp Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0707199) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Balboa Nephrology Med Grp Inc was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.