DR. MELISSA RENE BALBUENA-ROOT MD
NPI 1912360884
Psychiatry & Neurology - Clinical Neurophysiology in Peoria, AZ

Medicare Participation & PECOS Enrollment Status

Melissa Balbuena-root is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Melissa Balbuena-root is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 1052711082

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20210614001752, I20210615002733, I20241205001300, I20250131000197

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)

Continuous intraoperative neurophysiology monitoring is a service where a specialist oversees your nervous system's function during surgery, from a nearby or remote location. This is done every 15 minutes and is focused solely on you. It helps ensure surgical safety by identifying any potential nervous system changes promptly.

This service was performed 1,321 times for 329 patients

Measurement of brain wave activity (eeg) outside the brain during surgery

An EEG (Electroencephalogram) during surgery monitors brain activity. Electrodes on the scalp record brain wave patterns, helping doctors ensure the brain is functioning normally throughout the procedure.

This service was performed 217 times for 214 patients

Needle measurement of electrical activity in arm or leg muscles, 2 extremities

This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. It helps diagnose conditions affecting nerves or muscles. It's generally painless, though you may feel some discomfort.

This service was performed 171 times for 168 patients

Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study

This procedure, known as an electromyography (EMG), involves using a needle to measure electrical activity in your muscles. It can help diagnose conditions affecting nerves or muscles. It's a limited study, meaning only specific muscles in the arm, leg, trunk, or head are examined.

This service was performed 155 times for 113 patients

Placement of skin electrodes and measurement of central motor stimulation in arms and legs

This procedure involves placing small patches (electrodes) on your skin over your arms and legs. These electrodes send harmless electrical signals to your muscles. The response is measured to assess the health and function of your nerves and muscles.

This service was performed 122 times for 120 patients

Placement of skin electrodes and measurement of stimulated sites on arms and legs

This procedure involves placing small pads (electrodes) on your arms and legs. These electrodes send gentle electric signals to specific areas, and the responses are measured. This helps assess the health of your nerves and muscles.

This service was performed 322 times for 318 patients

Testing of nerve-muscle junction

Testing of the nerve-muscle junction, also known as Electromyography (EMG), is a diagnostic procedure to evaluate the health of muscles and the nerve cells that control them. It involves a small device detecting electrical activity from your muscles to identify potential issues.

This service was performed 285 times for 281 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Melissa Balbuena-root is affiliated with the following medical facilities:

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Frequently Asked Questions