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R S BALBOA MDPC
NPI 1801024807
Internal Medicine in Port Huron, MI

Active since June 29, 2009
1201 STONE ST STE 5, PORT HURON, MI 48060(810) 966-9556(810) 966-4898 Get Directions Write a Review

NPPES record last updated: December 15, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About R S Balboa Mdpc NPPES

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

R S BALBOA MDPC (NPI 1801024807) is a healthcare organization registered as an internal medicine in Port Huron, Michigan and active in the NPI registry since June 2009. The organization lists Ronaldo S Balboa, Owner, as its authorized official.

NPPES Registry Identity

NPI1801024807
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameR S BALBOA MDPC
Location Address1201 STONE ST STE 5Port Huron, MI 48060-3563
Mailing Address1201 Stone St Ste 5Port Huron, MI 48060-3563 · (810) 966-9556 · Fax (810) 966-4898
Phone(810) 966-9556
Fax(810) 966-4898
Organization SubpartNo
Authorized OfficialRonaldo S BalboaOwner · (810) 966-9556
Enumeration DateJune 29, 2009
Last NPPES UpdateDecember 15, 2009
✔ NPI 1801024807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · RB028997
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1201 STONE ST STE 5, Port Huron, MI 48060
Open in Google Maps ↗

Other Identifiers 4

Medicaid1006297MI
Other110094613MI · Railroad Medicare
Other0740374MI · Bcbsm
Medicare PIN0740374MI

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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

R S Balboa Mdpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20090728000359Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to R S Balboa Mdpc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ronaldo Balboa, M.D.
Internal Medicine
NPI 1417941055
1201 STONE ST STE. 5
Port Huron, MI 48060
(810) 966-9556
✔ PECOS✔ Accepts MedicareSame address

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

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 R S Balboa Mdpc's NPI number?

The NPI number for R S Balboa Mdpc is 1801024807. It was assigned to this organization in the NPPES registry on June 29, 2009.

Where is R S Balboa Mdpc located?

R S Balboa Mdpc is located at 1201 Stone St Ste 5, Port Huron, MI 48060. The listed phone number is (810) 966-9556.

What is R S Balboa Mdpc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is R S Balboa Mdpc enrolled in Medicare?

Yes. R S Balboa Mdpc is registered in the Medicare PECOS enrollment system.

When is R S Balboa Mdpc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through R S Balboa Mdpc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to R S Balboa Mdpc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does R S Balboa Mdpc accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list R S Balboa Mdpc 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.

When was this NPI record last updated?

The NPPES record for R S Balboa Mdpc was last updated on December 15, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.