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DR. ALBERTO BALLESTEROS MD
NPI 1972527430
Psychiatry & Neurology - Psychiatry in Toms River, NJ

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment
93.71/100
CMS Quality Rating
1691 ROUTE 9, TOMS RIVER, NJ 08755(732) 914-3843 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Alberto Ballesteros Md NPPES

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

DR. ALBERTO BALLESTEROS MD (NPI 1972527430) is an individual psychiatry provider in Toms River, New Jersey, licensed in New Jersey (MA062012) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (1982).

NPPES Registry Identity

NPI1972527430
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. ALBERTO BALLESTEROSCredential: MD
Location Address1691 ROUTE 9Toms River, NJ 08755-1245
Mailing Address1691 Route 9Toms River, NJ 08755-1245 · (732) 914-3843
Phone(732) 914-3843
Sole ProprietorYes
Medical School CMSOtherGraduated 1982
Enumeration DateJuly 27, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1972527430 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in NJ · MA062012
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1691 ROUTE 9, Toms River, NJ 08755
Open in Google Maps ↗

Other Identifiers 1

Medicare UPING46019

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Dr. Alberto Ballesteros 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 ID5890883342
PECOS Enrollment IDI20071116000013
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
761 services192 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
512 services194 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.
356 services161 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
143 services121 patients
Psychiatric diagnostic evaluation 90791
A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
117 services109 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Monmouth Medical Center-Southern Campus

Acute Care Hospitals · Lakewood, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310084
Location600 River AveLakewood, NJ 08701 · Ocean County
Emergency services

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 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
$185.05 typical visit price
range $61.59 – $185.05
Typical copayment $46.26 (range $15.39 – $46.26)
Most-billed visit code 99205
Established Patient
$76.45 typical visit price
range $20.08 – $150.98
Typical copayment $19.11 (range $5.02 – $37.74)
Most-billed visit code 99213
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.

93.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.79
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CHERYL CAPUTO LCSW
Social Worker (Clinical)
1691 ROUTE 9
TOMS RIVER, NJ 08755
Ocean County (732) 914-3848
SAINT BARNABAS BEHAVIORAL HEALTH CENTER INC
Psychiatric Hospital
1691 ROUTE 9
TOMS RIVER, NJ 08755
Ocean County (732) 914-1688
JAIME LEE BASILE LCSW
Social Worker (Clinical)
1691 ROUTE 9
TOMS RIVER, NJ 08755
Ocean County (732) 914-3848
ELLEN MARIE RICCI APRN
Clinical Nurse Specialist (Psychiatric/Mental Health)
1691 ROUTE 9, CN 2025 SAINT BARNABAS BEHAVIORAL HEALTH CENTER
TOMS RIVER, NJ 08755
Ocean County (732) 914-3843
DR. COREY JOSEPH WASSER DO
Psychiatry & Neurology (Psychiatry)
1691 ROUTE 9
TOMS RIVER, NJ 08755
Ocean County (732) 914-3864
DR. MURALIDHAR KRISHNAIAH MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1691 ROUTE 9, SAINT BARBABAS BEHAVIORAL HEALTH CENTER CN 2025
TOMS RIVER, NJ 08755
Ocean County (732) 914-3843
DR. MICHAEL JAMES MANDARINO PHARM.D., BCPS
Pharmacist (Psychiatric)
1691 ROUTE 9
TOMS RIVER, NJ 08755
Ocean County (732) 914-3826
MR. JARED GORSKY LCSW
Social Worker (Clinical)
1691 ROUTE 9
TOMS RIVER, NJ 08755
Ocean County (732) 240-7833

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 Alberto Ballesteros's NPI number?

The NPI number for Alberto Ballesteros is 1972527430. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Where is Alberto Ballesteros located?

Alberto Ballesteros practices at 1691 Route 9, Toms River, NJ 08755. The listed phone number is (732) 914-3843.

What is Alberto Ballesteros's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Alberto Ballesteros enrolled in Medicare?

Yes. Alberto Ballesteros 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 Alberto Ballesteros accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Alberto Ballesteros 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 Alberto Ballesteros affiliated with any hospitals?

According to CMS data, Alberto Ballesteros is affiliated with Community Medical Center, Monmouth Medical Center-Southern Campus and Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Alberto Ballesteros was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.