SYLWIA MONIKA BALAGA APRN
NPI 1821673534
Nurse Practitioner - Family in Naperville, IL

Active since March 15, 2021PECOS EnrolledAccepts Medicare Assignment
82.3/100
CMS Quality Rating
1299 E OGDEN AVE, NAPERVILLE, IL 60563(866) 389-2727 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 1, 2025, Feb 4, 2022, Jan 20, 2022 and 3 more (6 updates tracked since 2021).

About Sylwia Monika Balaga Aprn NPPES

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

SYLWIA MONIKA BALAGA APRN (NPI 1821673534) is an individual family provider in Naperville, Illinois, licensed in Illinois (209022955) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1821673534
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSYLWIA MONIKA BALAGACredential: APRN
Location Address1299 E OGDEN AVENaperville, IL 60563-1603
Mailing Address234 Meadows DrSugar Grove, IL 60554-5003 · (630) 340-1414
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateMarch 15, 2021
Last NPPES UpdateApril 1, 20256 updates tracked since enumeration
NPPES CertifiedApril 1, 2025
NPI 1821673534 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in IL · 209022955
1299 E OGDEN AVE, Naperville, IL 60563

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

Sylwia Monika Balaga Aprn 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 ID143619254
PECOS Enrollment IDI20211111000690
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 5

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 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.
34 services31 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
33 services33 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
24 services24 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
22 services22 patients
Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique 87651
This test detects Group A Streptococcus bacteria in your body. It uses an amplified probe technique, which amplifies the bacteria's nucleic acid, making it easier to identify. This test helps diagnose conditions like strep throat or scarlet fever.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60563 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

82.3/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.7
Improvement Activities40
Cost81.88

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.

Pharmacist
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Pharmacist
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Nurse Practitioner (Family)
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Nurse Practitioner (Family)
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Pharmacy
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Pharmacist
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Nurse Practitioner (Family)
1299 E OGDEN AVE
NAPERVILLE, IL 60563
Nurse Practitioner (Family)
1299 E OGDEN AVE
NAPERVILLE, IL 60563

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 Sylwia Balaga's NPI number?

The NPI number for Sylwia Balaga is 1821673534. It was assigned to this individual provider in the NPPES registry on March 15, 2021.

Where is Sylwia Balaga located?

Sylwia Balaga practices at 1299 E Ogden Ave, Naperville, IL 60563. The listed phone number is (866) 389-2727.

What is Sylwia Balaga's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Sylwia Balaga enrolled in Medicare?

Yes. Sylwia Balaga 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 Sylwia Balaga accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Sylwia Balaga 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 Sylwia Balaga was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.