DAVID S BALLESTAS MD
NPI 1609969419
Internal Medicine in Port Charlotte, FL

NPI Status: Active since October 02, 2006

Contact Information

2525 HARBOR BLVD
SUITE 102
PORT CHARLOTTE, FL
ZIP 33952
Phone: (941) 629-7593
Fax: (941) 625-2751

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  • Individual
  • Male
  • Years of Experience 46
  • Internal Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting
  • CLIA Number: 10D0294616
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-25-2026

About DAVID BALLESTAS

This page provides the complete NPI Profile along with additional information for David Ballestas, an internist established in Port Charlotte, Florida with a medical specialization in Internal Medicine and more than 46 years of experience. The healthcare provider is registered in the NPI registry with number 1609969419 assigned on October 2006. The practitioner's primary taxonomy code is 207R00000X with license number ME0044391 (FL). The provider is registered as an individual and his NPI record was last updated 17 years ago.

NPI
1609969419
Provider Name
DAVID S BALLESTAS MD
Gender
Male
Entity Type
Individual
Location Address
2525 HARBOR BLVD SUITE 102 PORT CHARLOTTE, FL 33952
Location Phone
(941) 629-7593
Location Fax
(941) 625-2751
Mailing Address
2525 HARBOR BLVD SUITE 102 PORT CHARLOTTE, FL 33952
Mailing Phone
(941) 629-7593
Mailing Fax
(941) 625-2751
Medical School Name
OTHER
Graduation Year
1980
Is Sole Proprietor?
No
Enumeration Date
10-02-2006
Last Update Date
05-09-2008
Code Navigator

An internist like David Ballestas is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

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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

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
ME0044391
License State
FL
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

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)
1208D00000XAllopathic & Osteopathic Physicians

General Practice

ME0044391 (FL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
  • BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - PPO
  • BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) - PPO
  • BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) - PPO
  • BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - PPO
  • BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - PPO
  • BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) - PPO
  • BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - PPO
  • BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) - PPO
  • BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
  • BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - EPO
  • BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - EPO
  • BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
  • BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) - EPO
  • BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) - EPO
  • BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
  • BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) - POS
  • BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) - POS
  • BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) - POS
  • BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) - POS
  • BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) - POS
  • BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) - POS
  • BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) - POS
  • BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) - POS
  • BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
  • BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) - POS
  • BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) - POS
  • BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) - POS

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
068916500MEDICAID (05)FL 
D84985MEDICARE UPIN (02) 
4617940001MEDICARE NSC (07)FL 
08137ZMEDICARE PIN (08)FL 

Medicare Participation & PECOS Enrollment Status

David Ballestas 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.

David Ballestas 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: 5395647515

    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: I20120330000074

    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

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.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    12 DME suppliers used 23 Medicare Claims 91 Services Paid

  • DME-Other DME (DE001N)

    Tubing with integrated heating element for use with positive airway pressure device (HCPCS:A4604)

    2 DME suppliers used 19 Medicare Claims 19 Services Paid

  • DME-Other DME (DE000N)

    Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable (HCPCS:A7005)

    4 DME suppliers used 11 Medicare Claims 11 Services Paid

  • DME-Other DME (DE001N)

    Full face mask used with positive airway pressure device, each (HCPCS:A7030)

    3 DME suppliers used 17 Medicare Claims 17 Services Paid

  • DME-Other DME (DE001N)

    Face mask interface, replacement for full face mask, each (HCPCS:A7031)

    3 DME suppliers used 16 Medicare Claims 48 Services Paid

  • DME-Other DME (DE001N)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    3 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Other DME (DE001N)

    Filter, disposable, used with positive airway pressure device (HCPCS:A7038)

    2 DME suppliers used 15 Medicare Claims 90 Services Paid

  • DME-Other DME (DE000N)

    Walker, with trunk support, adjustable or fixed height, any type (HCPCS:E0140)

    1 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Oxygen and Supplies (DC000N)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 12 Medicare Claims 12 Services Paid

  • DME-Other DME (DE000N)

    Nebulizer, with compressor (HCPCS:E0570)

    3 DME suppliers used 65 Medicare Claims 65 Services Paid

  • DME-Other DME (DE001N)

    Continuous positive airway pressure (cpap) device (HCPCS:E0601)

    1 DME suppliers used 30 Medicare Claims 30 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    2 DME suppliers used 57 Medicare Claims 57 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    1 DME suppliers used 14 Medicare Claims 14 Services Paid

  • DME-Wheelchairs (DD000N)

    Standard wheelchair (HCPCS:K0001)

    3 DME suppliers used 29 Medicare Claims 29 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    7 DME suppliers used 42 Medicare Claims 44 Services Paid

  • DME-Other DME (DE000N)

    Pharmacy dispensing fee for inhalation drug(s); per 30 days (HCPCS:Q0513)

    5 DME suppliers used 59 Medicare Claims 59 Services Paid

Drugs Administered Through DME

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg (HCPCS:J7613)

    2 DME suppliers used 22 Medicare Claims 5174 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme (HCPCS:J7620)

    5 DME suppliers used 28 Medicare Claims 3840 Services Paid

  • DME-Drugs Administered Through DME (DG000N)

    Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg (HCPCS:J7626)

    3 DME suppliers used 46 Medicare Claims 2736 Services Paid

  • DME-Drugs Administered Through DME (DG006N)

    Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram (HCPCS:J7644)

    2 DME suppliers used 12 Medicare Claims 665 Services Paid

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.

Adm sarscov2 100mcg/0.5ml3rd

This is the administration of a third dose of a SARS-CoV-2 vaccine, given in a dose of 100 micrograms in 0.5 milliliters. This vaccine helps your body develop immunity against the COVID-19 virus. It's a crucial step in protecting your health.

This service was performed 32 times for 32 patients

Adm sarscov2 50mcg/0.25mlbst

This procedure involves administering a dose of a SARS-CoV-2 vaccine. The specific dosage is 50 micrograms in a 0.25 milliliter booster shot. This vaccine helps your body build immunity against the COVID-19 virus. It's a key part of global efforts to control the pandemic.

This service was performed 48 times for 48 patients

Administration of influenza virus vaccine

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

This service was performed 48 times for 46 patients

Administration of pneumococcal vaccine

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

This service was performed 18 times for 18 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

This service was performed 148 times for 148 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

This service was performed 79 times for 79 patients

Automated urinalysis test

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

This service was performed 81 times for 62 patients

Coronavirus vaccine 14

The Coronavirus Vaccine 14 is an injection designed to protect you from COVID-19. It works by teaching your immune system how to fight the virus. After vaccination, your body is better equipped to combat the virus if exposed, reducing your risk of severe illness. It's a key step in controlling the pandemic.

This service was performed 30 times for 30 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

This service was performed 286 times for 213 patients

Detection test by immunoassay with direct visual observation for influenza virus

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

This service was performed 38 times for 19 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 1,116 times for 505 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 33 times for 32 patients

Fee covid-19 vac 14 res

The "Fee covid-19 vac 14 res" refers to a charge for a specific service related to the COVID-19 vaccine. This could be for administering the vaccine or related care. It's crucial to get vaccinated to protect against the virus. The fee ensures quality service.

This service was performed 30 times for 30 patients

Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage

The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.

This service was performed 48 times for 46 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 13 times for 12 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 220 times for 220 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 29 times for 29 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

This service was performed 94 times for 61 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

This service was performed 34 times for 24 patients

Pneumococcal vaccine, 13-valent

The 13-valent pneumococcal vaccine is a shot that helps protect against 13 types of bacteria that can cause serious infections like pneumonia and meningitis. It's often recommended for children under 2 and adults over 65, or people with certain health conditions.

This service was performed 14 times for 14 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 273 times for 263 patients

Sarscov2 vac 50mcg/0.25ml im

The Sarscov2 vac 50mcg/0.25ml im is a COVID-19 vaccine. It's administered as an intramuscular injection, typically in the arm. The vaccine helps your body develop immunity to the virus, reducing your risk of severe illness.

This service was performed 35 times for 35 patients

Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage, for intramuscular use

The COVID-19 mRNA vaccine is a shot that boosts your body's natural defenses against the virus. It contains a small piece of the virus's spike protein, which triggers your immune system to build a response. It's free of preservatives, given in a 100 mcg dose, and is injected into a muscle.

This service was performed 44 times for 43 patients

Transitional care management services for problem of high complexity

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

This service was performed 30 times for 27 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

This service was performed 42 times for 42 patients

X-ray of chest, 2 views

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

This service was performed 100 times for 90 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.51 for a new patient copayment and $24.79 for an established patient copayment.

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 33952 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.04
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $32.51
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* 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.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Adult Major Depressive Disorder (MDD): Suicide Risk Assessment 71% 41
Percentage of patients aged 18 years and older with a diagnosis of major depressive disorder (MDD) with a suicide risk assessment completed during the visit in which a new diagnosis or recurrent episode was identified
Annual registration in the Prescription Drug Monitoring ProgramYesN/A
Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months.
Breast Cancer Screening 0% 650
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Closing the Referral Loop: Receipt of Specialist Report 100% 186
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Colorectal Cancer Screening 0% 1350
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Consultation of the Prescription Drug Monitoring ProgramYesN/A
Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance.
Documentation of Current Medications in the Medical Record 28% 2583
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of patients through implementation of improvements in patient portalYesN/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing 95% 1331
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange 82% 22
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Medication Reconciliation 66% 146
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 23% 610
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults 1% 1042
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 32% 2349
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Influenza Immunization 5% 2656
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Provide Patient Access 20% 610
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 43% 610
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Tobacco useYesN/A
Tobacco use: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including tobacco use screening and cessation interventions (refer to NQF #0028) for patients with co-occurring conditions of behavioral or mental health and at risk factors for tobacco dependence.
Use of High-Risk Medications in the Elderly 10% "Inverse Quality Measure"
This is an inverse quality measure, a lower rate means the provider is rated better.
981
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication

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. David Ballestas is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HCA FLORIDA FAWCETT HOSPITAL21298 OLEAN BLVD
PORT CHARLOTTE, FL 33952
(941) 629-1181Acute Care Hospitals

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D0294616
Facility Type
Physician Office
Certificate Effective Date
August 26, 2024
Certificate Expiration Date
August 25, 2026
Laboratory Director
DAVID S. BALLESTAS MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to David Ballestas to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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.
1609969419
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26091861842
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 0 + 9 + 1 + 8 + 6 + 1 + 8 + 4 + 2 + 24 = 71
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 71 = 99

The NPI number 1609969419 is valid because the calculated check digit 9 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
1275526097DR. ALEJANDRO CALLEJAS MD
Individual
Surgery2525 HARBOR BLVD 203
PORT CHARLOTTE, FL 33952
(941) 627-9119
1780668699 JOE BUTLER JR. MD
Individual
Surgery2525 HARBOR BLVD STE 309
PORT CHARLOTTE, FL 33952
(941) 629-7597
1841265923DR. EUGENE ERVIN GREGUSH M.D.
Individual
Obstetrics & Gynecology2525 HARBOR BLVD SUITE 201A
PORT CHARLOTTE, FL 33952
(941) 624-3500
1821051160 STEPHEN PETROFSKY D.P.M.
Individual
Podiatrist (Foot Surgery)2525 HARBOR BLVD SUITE 206
PT CHARLOTTE, FL 33952
(941) 625-3330
1851339535CALLMAN AND VALENTE M D S PA
Organization
Internal Medicine2525 HARBOR BLVD #104
PORT CHARLOTTE, FL 33952
(941) 629-5757
1144260399DR. JEROME B COHEN MD
Individual
Internal Medicine2525 HARBOR BLVD 104
PORT CHARLOTTE, FL 33952
(941) 629-5757
1699719468 MAMOON JARRAH MD
Individual
Surgery (Vascular Surgery)2525 HARBOR BLVD SUITE 202
PORT CHARLOTTE, FL 33952
(941) 613-3773
1487698700ALL VEIN CLINIC INC
Organization
Surgery (Vascular Surgery)2525 HARBOR BLVD SUITE 202
PORT CHARLOTTE, FL 33952
(941) 766-8346
1508872979HOWARD F SASLOW MD PA
Organization
Orthopaedic Surgery2525 HARBOR BLVD STE 202
PORT CHARLOTTE, FL 33952
(941) 629-2334
1104993849DR. ANTONIO LABITAG GABARDA M.D.
Individual
Internal Medicine (Hematology & Oncology)2525 HARBOR BLVD SUITE 205
PORT CHARLOTTE, FL 33952
(941) 629-4660
1093901282DAVID S BALLESTAS MD PA
Organization
Specialist2525 HARBOR BLVD SUITE 102
PORT CHARLOTTE, FL 33952
(941) 629-7593
1497942494JOE BUTLER JR MD PA
Organization
Specialist2525 HARBOR BLVD SUITE 309
PORT CHARLOTTE, FL 33952
(941) 629-7597
1063686756STEPHEN PETROFSKY DPM PA
Organization
Durable Medical Equipment & Medical Supplies2525 HARBOR BLVD SUITE 206
PT CHARLOTTE, FL 33952
(941) 625-3330
1063671683MEDICAL PAVILION CLINC
Organization
Preferred Provider Organization2525 HARBOR BLVD SUITE 102
PORT CHARLOTTE, FL 33952
(941) 629-9190
1568622579THE NEUROHEALTH SCIENCE CENTER LLC DBA CHARLOTTE NEUROSURGERY
Organization
Neurological Surgery2525 HARBOR BLVD STE 208
PORT CHARLOTTE, FL 33952
(941) 629-7920
1548408073ALEJANDRO CALLEJAS MD
Organization
Surgery2525 HARBOR BLVD STE 203
PORT CHARLOTTE, FL 33952
(941) 627-9119
1528377827EUGENE E GREGUSH MD PA
Organization
Obstetrics & Gynecology2525 HARBOR BLVD STE 201A
PORT CHARLOTTE, FL 33952
(941) 624-3500
1043449960 MICHAEL JAMES LAWSON ARNP
Individual
Nurse Practitioner2525 HARBOR BLVD SUITE 102
PORT CHARLOTTE, FL 33952
(941) 629-9190
1487834263MAMOON JARRAH MD PA
Organization
Specialist2525 HARBOR BLVD SUITE 202
PORT CHARLOTTE, FL 33952
(941) 613-3773
1669453270 JAMES P BARTEK MD
Individual
Surgery (Vascular Surgery)2525 HARBOR BLVD UNIT 201B
PORT CHARLOTTE, FL 33952
(941) 625-4357

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609969419, enumerated in the NPI registry as an "individual" on October 02, 2006

The provider is located at 2525 Harbor Blvd Suite 102 Port Charlotte, Fl 33952 and the phone number is (941) 629-7593

The provider's speciality is Internal Medicine with taxonomy code 207R00000X

The provider has more than 46 years of experience.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Florida. 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 $130.04 with an average copayment of $32.51 for new patient appointments. Established patients should expect a typical charge of $99.16 and an average copayment of 24.79. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Adm sarscov2 100mcg/0.5ml3rd, Adm sarscov2 50mcg/0.25mlbst, Administration of influenza virus vaccine, Administration of pneumococcal vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit, Automated urinalysis test, Coronavirus vaccine 14, Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus, Detection test by immunoassay with direct visual observation for influenza virus, Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes, Fee covid-19 vac 14 res, Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage, Injection of drug or substance under skin or into muscle, New patient office or other outpatient visit, 45-59 minutes, New patient office or other outpatient visit, 60-74 minutes, Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional, Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and, Pneumococcal vaccine, 13-valent, Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report, Sarscov2 vac 50mcg/0.25ml im, Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage, for intramuscular use, Transitional care management services for problem of high complexity, Ultrasound of heart with color-depicted blood flow, rate, direction and valve function and X-ray of chest, 2 views.

The provider's CLIA number is 10D0294616 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

The practitioner is affiliated to the following hospital(s): HCA FLORIDA FAWCETT HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on October 02, 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].
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