KAREN K. BALLEN MD
NPI 1821089558
Internal Medicine - Hematology in Falls Church, VA
About Karen K. Ballen Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAREN K. BALLEN MD (NPI 1821089558) is an individual hematology provider in Falls Church, Virginia, licensed in Virginia (0101261336) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS, is affiliated with Sentara Rmh Medical Center, and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Locations 2
Other Identifiers 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Karen K. Ballen Md 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.
Medicare Billing Reassignments
3Medicare enrollment records show Karen Ballen reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Falls Church, VA 22042
- Reassigned Medicare billing, District of Columbia enrollment
- Also billed through NPI 1275097123 (District of Columbia)
- 2,618 clinicians in this Medicare group
Charlottesville, VA 22911
- Reassigned Medicare billing, Virginia enrollment
- 2,820 clinicians in this Medicare group
Farmville, VA 23901
- Reassigned Medicare billing, Virginia enrollment
- 757 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 7
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.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Sentara Rmh Medical Center
Acute Care Hospitals · Harrisonburg, VAUniversity Of Virginia Medical Center
Acute Care Hospitals · Charlottesville, VACentra Health - Lynchburg Gen Hospital
Acute Care Hospitals · Lynchburg, VANovant Prince William Medical Center
Acute Care Hospitals · Manassas, VAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 22042 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
FALLS CHURCH, VA 22042
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 Karen Ballen's NPI number?
The NPI number for Karen Ballen is 1821089558. It was assigned to this individual provider in the NPPES registry on November 2, 2005.
Where is Karen Ballen located?
Karen Ballen practices at 3300 Gallows Rd, Falls Church, VA 22042. The listed phone number is (571) 423-5699.
What is Karen Ballen's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.
Is Karen Ballen enrolled in Medicare?
Yes. Karen Ballen 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.
Which organizations bill Medicare for Karen Ballen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Karen Ballen reassigns Medicare benefits to 3 organizations: Inova Health Care Services (Falls Church, VA), University Of Virginia Physicians Group (Charlottesville, VA) and Centra Medical Group. LLC (Farmville, VA). Each 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 Karen Ballen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Karen Ballen accept?
Health plans from Oscar Health and Taro Health list Karen Ballen 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 Karen Ballen affiliated with any hospitals?
According to CMS data, Karen Ballen is affiliated with Sentara Rmh Medical Center, University Of Virginia Medical Center, Centra Health - Lynchburg Gen Hospital and Novant Prince William Medical Center.
When was this NPI record last updated?
The NPPES record for Karen Ballen was last updated on August 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Karen K. Ballen, MD · NPI 1821089558
Hematology physician in Falls Church, Virginia. Individual provider, active in the CMS NPPES registry since November 2, 2005.
## Identity
- **NPI:** 1821089558 (Entity type: Individual)
- **Enumerated:** November 2, 2005
- **Primary specialty:** Internal Medicine - Hematology · taxonomy 207RH0000X
- **State license:** 0101261336 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 3300 GALLOWS RD, Falls Church, VA 22042-3307
- **Phone:** (571) 423-5699
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Inova Health Care Services (NPI 1952320061, Falls Church, VA); University Of Virginia Physicians Group (NPI 1033138250, Charlottesville, VA); Centra Medical Group. LLC (NPI 1336638865, Farmville, VA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1982
## Record status
- **NPPES last updated:** August 8, 2023
- **Other identifiers:** Other 070975 (MA); Medicaid 3092046 (MA); Other J12406 (MA)
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Source: [NPI Profile](https://npiprofile.com/npi/1821089558) · Data from the CMS NPPES public registry.