KAREN K. BALLEN MD
NPI 1821089558
Internal Medicine - Hematology in Falls Church, VA

Q: 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.

Q: What is Karen Ballen's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Q: 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.

Active since November 02, 2005PECOS EnrolledAccepts Medicare Assignment

94.07/100

CMS Quality Rating

3300 GALLOWS RD, FALLS CHURCH, VA 22042(571) 423-5699 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 8, 2023, Aug 2, 2022, Jul 30, 2021 and 2 more (5 updates tracked since 2017).

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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

NPI1821089558

Entity TypeIndividualFemale

Primary Taxonomy207RH0000X

Provider Legal NameKAREN K. BALLENCredential: MD

Location Address3300 GALLOWS RDFalls Church, VA 22042-3307

Mailing AddressPo Box 37174Baltimore, MD 21297-3174 · (571) 423-5741

Phone(571) 423-5699

Sole ProprietorNo

Medical School CMSOtherGraduated 1982

Enumeration DateNovember 2, 2005

Last NPPES UpdateAugust 8, 20235 updates tracked since enumeration

NPPES CertifiedAugust 8, 2023

✔ NPI 1821089558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0000X

License✔ Licensed in VA · 0101261336

Definition

An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.

Also ListedInternal MedicineTaxonomy 207R00000X · License 70975 (MA)

Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 70975 (MA)

Also ListedInternal Medicine · HepatologyTaxonomy 207RI0008X · License 0101261336 (VA)

3300 GALLOWS RD, Falls Church, VA 22042

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Secondary Practice Locations 2

Location 11240 Lee StCharlottesville, VA 22908-0001 · Phone (434) 924-9333 · Fax (434) 244-7526

Location 21215 Lee StCharlottesville, VA 22908-3307 · Phone (434) 924-0211

Other Identifiers 3

Other070975MA · Tufts Health Plan

Medicaid3092046MA

OtherJ12406MA · Bcbs Ma

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

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.

PECOS PAC ID2567445968

PECOS Enrollment IDI20170220001486

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 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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

120 services57 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.

88 services42 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

83 services47 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

64 services19 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

22 services22 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

20 services11 patients

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, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490004

Location2010 Health Campus DriveHarrisonburg, VA 22801 · Harrisonburg City County

Emergency services Birthing friendly

University Of Virginia Medical Center

Acute Care Hospitals · Charlottesville, VA

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number490009

Location1215 Lee StreetCharlottesville, VA 22908 · Charlottesville City County

Emergency services Birthing friendly

Centra Health - Lynchburg Gen Hospital

Acute Care Hospitals · Lynchburg, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490021

Location1901 Tate Springs RoadLynchburg, VA 24501 · Lynchburg City County

Emergency services Birthing friendly

Novant Prince William Medical Center

Acute Care Hospitals · Manassas, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490045

Location8700 Sudley RdManassas, VA 20110 · Manassas City County

Emergency services Birthing friendly

Physician 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.

New Patient

$194.86 typical visit price

range $65.18 – $194.86

Typical copayment $48.71 (range $16.29 – $48.71)

Most-billed visit code 99205

Established Patient

$113.72 typical visit price

range $21.40 – $158.88

Typical copayment $28.43 (range $5.35 – $39.72)

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.

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.

94.07/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.44

Promoting Interoperability

Improvement Activities

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.

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers16 claims2,687 services$0.15 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511

Treatment-Chemotherapy · category RH012N

3 suppliers11 claims11 services$18.92 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ALLISON ELIZABETH TWEEDIE MD

Psychiatry & Neurology (Psychiatry)