DR. ANTHONY H BALCOM MD
NPI 1487604906
Urology - Pediatric Urology in Hales Corners, WI
NPI Status: Active since May 12, 2006
Contact Information
5250 S 108TH ST
HALES CORNERS, WI
ZIP 53130
Phone: (414) 525-2400
Fax: (414) 525-2401
- Individual
- Male
- Urology
- Pediatric Urology
- Accepts Insurance
- PECOS Enrolled
About ANTHONY BALCOM
This page provides the complete NPI Profile along with additional information for Anthony Balcom, a provider established in Hales Corners, Wisconsin with a medical specialization in Urology, focusing in pediatric urology . The healthcare provider is registered in the NPI registry with number 1487604906 assigned on May 2006. The practitioner's primary taxonomy code is 2088P0231X with license number 26912 (WI). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1487604906
- Provider Name
- DR. ANTHONY H BALCOM MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5250 S 108TH ST HALES CORNERS, WI 53130
- Location Phone
- (414) 525-2400
- Location Fax
- (414) 525-2401
- Mailing Address
- 5250 S 108TH ST HALES CORNERS, WI 53130
- Mailing Phone
- (414) 525-2400
- Mailing Fax
- (414) 525-2401
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-12-2006
- Last Update Date
- 11-19-2021
- Code Navigator
Location Map
Secondary Locations
- 9000 W Wisconsin Ave PEDIATRIC UROLOGY
Milwaukee, WI 53226
(414) 266-3794 - 9000 W Wisconsin Ave PEDIATRIC UROLOGY
Milwaukee, WI 53226
(414) 266-3794
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
Urology Pediatric Urology
- Taxonomy Code
- 2088P0231X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 26912
- License State
- WI
- Taxonomy Description
- Surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208800000X | Allopathic & Osteopathic Physicians | Urology | 26912 (WI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
- Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
- Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 7500 - HMO
- HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
- HMO Gold 1500 - HMO
- HMO Gold 2400 - HMO
- HMO HDHP Bronze 7200 - HMO
- HMO HDHP Silver 5400 - HMO
- HMO Silver 5000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- POS HDHP Bronze 6250 - POS
- POS Silver 5000 - POS
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
- CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
- CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
- CGHC Bronze Standard $7500 - Envision Network - EPO
- CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
- CGHC Catastrophic $9200 - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network - EPO
- CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
- CGHC Gold $3000 - Envision Network - EPO
- CGHC Gold $3000 - Envision Network (Vision Exam) - EPO
- CGHC Gold Standard $1500 - Envision Network - EPO
- CGHC Gold Standard $1500 - Envision Network (Vision Exam) - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network - EPO
- CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network - EPO
- CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) - EPO
- CGHC Silver Standard $5000 - Envision Network - EPO
- CGHC Silver Standard $5000 - Envision Network (Vision Exam) - EPO
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $500 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $0 DED FLAT RX COPAYS - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $7000 DED - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
- QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) $9100 DED FLAT RX COPAYS - IL - HMO
- QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (Rx Copay, No Referrals) - HMO
- UHC Bronze Value HSA (No Referrals) - HMO
- UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Gold Standard (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage (Rx Copay, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) - HMO
- UHC Silver Copay Focus (No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - 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.
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 |
|---|---|---|---|
| 1487604906 | MEDICAID (05) | WI | |
| 007000261M | OTHER (01) | HUMANA |
Medicare Participation & PECOS Enrollment Status
Anthony Balcom 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
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF008N)
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each (HCPCS:A4352)
1 DME suppliers used 11 Medicare Claims 2200 Services Paid
Reviews for DR. ANTHONY H BALCOM MD
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
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 | 4 | 8 | 7 | 6 | 0 | 4 | 9 | 0 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 16 | 7 | 12 | 0 | 8 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 6 + 7 + 1 + 2 + 0 + 8 + 9 + 0 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1487604906 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 17 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1285819862 | AURORA MEDICAL GROUP, INC. Organization | Durable Medical Equipment & Medical Supplies | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 525-2400 |
| 1295911618 | SPORTS MEDICINE & ORTHOPEDIC CENTER, S.C. Organization | Specialist | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 647-0033 |
| 1740589399 | LAKESHORE MEDICAL CLINIC LTD Organization | Durable Medical Equipment & Medical Supplies | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 525-2433 |
| 1154640944 | DR. ELIZABETH HOOVER EICHE D.D.S. Individual | Dentist (General Practice) | 5250 S 108TH ST SUITE 200 HALES CORNERS, WI 53130 (414) 427-0900 |
| 1427401033 | DR. MICHAEL ADAM BURKHARDT D.M.D. Individual | Dentist (General Practice) | 5250 S 108TH ST #200 HALES CORNERS, WI 53130 (414) 427-0900 |
| 1336621978 | KAITLIN ANTOINETTE KROEGER MSW, LCSW Individual | Social Worker (Clinical) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1366136053 | HEIDI STUCKEY LPC Individual | Counselor (Professional) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1073292447 | BRIANNA N KIRNBAUER B.A PSYCHOLOGY Individual | Counselor (Mental Health) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1730954736 | MARY CLAIRE GINTOLI LPC-IT Individual | Counselor (Professional) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 975-1316 |
| 1386358596 | STIGMACURE SC Organization | Counselor (Professional) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 975-1316 |
| 1437728862 | SAMANTHA BARTLETT MS, LPC Individual | Counselor (Professional) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1477953057 | COLLEEN ALICIA CHRISTIANSEN MS, LPC Individual | Counselor (Mental Health) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1639563448 | JANIS A AVALOS RIOS MA, LPC Individual | Counselor (Professional) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1922601814 | LAUREN J MCCARTHY LPC, MS Individual | Counselor (Professional) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1407628167 | VICTORIA DUCOFFE Individual | Counselor (Mental Health) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
| 1801789110 | ASHLEY KITE Individual | Counselor (Mental Health) | 5250 S 108TH ST HALES CORNERS, WI 53130 (173) 041-4296 |
| 1588550909 | RILEY FUERSTENAU MS, LPC-IT Individual | Counselor (Mental Health) | 5250 S 108TH ST HALES CORNERS, WI 53130 (414) 296-1730 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1487604906, enumerated in the NPI registry as an "individual" on May 12, 2006
The provider is located at 5250 S 108th St Hales Corners, Wi 53130 and the phone number is (414) 525-2400
The provider's speciality is Urology with taxonomy code 2088P0231X with a focus in Pediatric Urology
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. 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.
This NPI record was last updated on May 12, 2006. 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].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.