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MS. HEATHER BALCH M.D.
NPI 1972892404
Hospitalist in Salt Lake City, UT

Active since April 05, 2011PECOS EnrolledAccepts Medicare Assignment
92.06/100
CMS Quality Rating
UNIV OF UTAH HOSP GEN MED DIVISION, 50 N MEDICAL DR., SALT LAKE CITY, UT 84132(801) 581-7818 Get Directions Write a Review

NPPES record last updated: October 19, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 19, 2021, Mar 31, 2021 (2 updates tracked since 2021).

About Ms. Heather Balch M.d. NPPES

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

MS. HEATHER BALCH M.D. (NPI 1972892404) is an individual hospitalist provider in Salt Lake City, Utah, licensed in Utah (8436300-1205) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, is affiliated with Northeastern Nevada Regional Hospital, and is a graduate of University Of New Mexico School Of Medicine (2011).

NPPES Registry Identity

NPI1972892404
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameMS. HEATHER BALCHCredential: M.D.
Location AddressUNIV OF UTAH HOSP GEN MED DIVISION, 50 N MEDICAL DR.Salt Lake City, UT 84132-0001
Mailing AddressMedicine Pediatrics University Of Utah, Po Box 413033Salt Lake City, UT 84141-3033 · (801) 581-7818
Phone(801) 581-7818
Sole ProprietorYes
Medical School CMSUniversity Of New Mexico School Of MedicineGraduated 2011
Enumeration DateApril 5, 2011
Last NPPES UpdateOctober 19, 20212 updates tracked since enumeration
NPPES CertifiedOctober 19, 2021
✔ NPI 1972892404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in UT · 8436300-1205
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 8436300-1205 (UT)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
UNIV OF UTAH HOSP GEN MED DIVISION, Salt Lake City, UT 84132
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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

Ms. Heather Balch M.d. 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 ID3375775877
PECOS Enrollment IDI20150717001143
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Heather Balch reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Pediatric Services
0.1 mi
Pediatric Otolaryngology
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 751 clinicians in this Medicare group
NPI 1063876100 (801) 587-6336
University Of Utah Adult Services
0.1 mi
Anesthesiology
30 N 1900 E, 3C 444
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 2,620 clinicians in this Medicare group
NPI 1720482599 (801) 587-6336

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 3

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
125 services121 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.
84 services39 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.
20 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Northeastern Nevada Regional Hospital

Acute Care Hospitals · Elko, NV
1/5 CMS rating
OwnershipProprietary
CMS Certification Number290008
Location2001 Errecart BlvdElko, NV 89801 · Elko County
Emergency services Birthing friendly

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

92.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.57
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$64.47 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Heather Balch's NPI number?

The NPI number for Heather Balch is 1972892404. It was assigned to this individual provider in the NPPES registry on April 5, 2011.

Where is Heather Balch located?

Heather Balch practices at Univ Of Utah Hosp Gen Med Division 50 N Medical Dr., Salt Lake City, UT 84132. The listed phone number is (801) 581-7818.

What is Heather Balch's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Heather Balch enrolled in Medicare?

Yes. Heather Balch 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 Heather Balch's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Heather Balch reassigns Medicare benefits to 2 organizations: University Of Utah Pediatric Services (Salt Lake City, UT) and University Of Utah Adult Services (Salt Lake City, UT). 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 Heather Balch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Heather Balch accept?

Health plans from Select Health list Heather Balch 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 Heather Balch affiliated with any hospitals?

According to CMS data, Heather Balch is affiliated with Northeastern Nevada Regional Hospital and University Of Utah Hospitals And Clinics.

When was this NPI record last updated?

The NPPES record for Heather Balch was last updated on October 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.