MR. CHARLES DOUGLAS BALCOME ACNP
NPI 1376027557
Nurse Practitioner - Acute Care in Phoenix, AZ
NPI Status: Active since September 24, 2018
Contact Information
16601 N 40TH ST STE 204
PHOENIX, AZ
ZIP 85032
Phone: (602) 633-3721
Fax: (602) 595-1127
- Individual
- Male
- Nurse Practitioner
- Acute Care
- Accepts Insurance
- PECOS Enrolled
About CHARLES BALCOME
This page provides the complete NPI Profile along with additional information for Charles Balcome, a provider established in Phoenix, Arizona with a medical specialization in Nurse Practitioner, focusing in acute care . The healthcare provider is registered in the NPI registry with number 1376027557 assigned on September 2018. The practitioner's primary taxonomy code is 363LA2100X with license number AP11604 (AZ). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1376027557
- Provider Name
- MR. CHARLES DOUGLAS BALCOME ACNP
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 16601 N 40TH ST STE 204 PHOENIX, AZ 85032
- Location Phone
- (602) 633-3721
- Location Fax
- (602) 595-1127
- Mailing Address
- 22331 N 79TH DR PEORIA, AZ 85383
- Mailing Phone
- (602) 335-9374
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-24-2018
- Last Update Date
- 10-20-2021
- Code Navigator
A nurse practitioner (NP) like Charles Balcome is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Acute Care
- Taxonomy Code
- 363LA2100X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- AP11604
- License State
- AZ
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Blue ACA StandardHealth Silver with Health Choice - HMO
- Blue Portfolio HSA Gold - Statewide PPO Network - PPO
- Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
- Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 443489 | MEDICAID (05) | AZ |
Medicare Participation & PECOS Enrollment Status
Charles Balcome 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
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
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 85032 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.89
- Minimum New Patient Price $55.44
- Maximum New Patient Price $168.6
- Average New Patient Copayment $21.47
- Minimum New Patient Copayment $13.86
- Maximum New Patient Copayment $42.15
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98
- Minimum Established Patient Price $17.72
- Maximum Established Patient Price $137.41
- Average Established Patient Copayment $24.5
- Minimum Established Patient Copayment $4.43
- Maximum Established Patient Copayment $34.35
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for MR. CHARLES DOUGLAS BALCOME ACNP
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 7 | 6 | 0 | 2 | 7 | 5 | 5 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 14 | 6 | 0 | 2 | 14 | 5 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 4 + 6 + 0 + 2 + 1 + 4 + 5 + 1 + 0 + 24 = 53 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 53 = 7 | 7 | ||||||||
The NPI number 1376027557 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1699027037 | DR. VARUN CHAKRAVORTY M.D. Individual | Surgery | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1114188950 | MR. SCOTT SHOLEM Individual | Surgery (Trauma Surgery) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1124204177 | DR. MEGHANN LEE KAISER M.D. Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1194047134 | DR. QAALI A HUSSEIN M.D. Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1326478017 | KIMBERLI BRUCE ACNP Individual | Nurse Practitioner (Acute Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1447430491 | DR. FRANCIS REGINALD ALI-OSMAN MD Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3722 |
| 1477021426 | JUSTIN THOMAS HALL ACNP Individual | Nurse Practitioner (Acute Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1649546193 | DR. ACE ASSAF OVIL M.D Individual | Surgery (Trauma Surgery) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1770515751 | JOSEPH FRANK SUCHER M.D. Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1831464858 | DR. ALYSSA KRISTINE STASSI D.O. Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1891012225 | HOANG LIM D.O. Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1922209600 | DR. SCOTT NICHOLAS WELLE DO Individual | Surgery | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1972575504 | DR. ALICIA MANGRAM MD Individual | Surgery (Surgical Critical Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1831707579 | DR. LANDON C RICHARDSON DNP Individual | Nurse Practitioner (Acute Care) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 633-3721 |
| 1174820542 | DR. NASRIN GHALYAIE M.D Individual | Colon & Rectal Surgery | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1023014016 | DR. SCOTT J HILLMANN M.D. Individual | Surgery | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1073541017 | DR. JEFFREY A SINGER MD Individual | Surgery | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1194911719 | DR. ROOZBEH RASSADI M.D. Individual | Surgery | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1306205331 | VALLEY MULTISPECIALTY CRITICAL CARE SERVICES LLC Organization | Internal Medicine (Critical Care Medicine) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
| 1316997349 | MRS. CYNTHIA J SHIVELY FNP-BC Individual | Nurse Practitioner (Family) | 16601 N 40TH ST STE 204 PHOENIX, AZ 85032 (602) 996-4747 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376027557, enumerated in the NPI registry as an "individual" on September 24, 2018
The provider is located at 16601 N 40th St Ste 204 Phoenix, Az 85032 and the phone number is (602) 633-3721
The provider's speciality is Nurse Practitioner with taxonomy code 363LA2100X with a focus in Acute Care
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Blue Cross. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $85.89 with an average copayment of $21.47 for new patient appointments. Established patients should expect a typical charge of $98 and an average copayment of 24.5. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on September 24, 2018. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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