PATRICIA CAROLINA GONZALEZ BALAGUER MD
NPI 1750953790
Family Medicine in Amery, WI
NPI Status: Active since July 09, 2021
- Individual
- Female
- Family Medicine
- Accepts Insurance
- PECOS Enrolled
About PATRICIA GONZALEZ BALAGUER
This page provides the complete NPI Profile along with additional information for Patricia Gonzalez Balaguer, a primary care provider established in Amery, Wisconsin with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1750953790 assigned on July 2021. The practitioner's primary taxonomy code is 207Q00000X with license number 83079 (WI). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1750953790
- Provider Name
- PATRICIA CAROLINA GONZALEZ BALAGUER MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 265 GRIFFIN ST E AMERY, WI 54001
- Location Phone
- (715) 268-8000
- Mailing Address
- 625 19TH ST S BIRMINGHAM, AL 35233
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-09-2021
- Last Update Date
- 07-30-2024
- Code Navigator
A primary care provider (PCP) like Patricia Gonzalez Balaguer sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 625 19th St S
Birmingham, AL 35233
(256) 551-4631
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 83079
- License State
- WI
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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
- Atlas $1,000 Gold - PPO
- Atlas $1,500 Standard Gold - PPO
- Atlas $2,650 Plus Silver - PPO
- Atlas $3,500 HSA Silver - PPO
- Atlas $5,000 Standard Silver - PPO
- Atlas $6,500 Plus Bronze - PPO
- Atlas $7,500 Standard Bronze - PPO
- Atlas $8,200 HSA Bronze - PPO
- Atlas $9,200 Catastrophic - PPO
- Robin Oak $1,000 Gold - PPO
- Robin Oak $1,500 Standard Gold - PPO
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Patricia Gonzalez Balaguer 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 54001 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.92
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $20.73
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.41
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $23.85
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* 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.
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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 | 7 | 5 | 0 | 9 | 5 | 3 | 7 | 9 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 18 | 5 | 6 | 7 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 8 + 5 + 6 + 7 + 1 + 8 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1750953790 is valid because the calculated check digit 0 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 |
|---|---|---|---|
| 1063417947 | DR. MARGIE H PETERSON MD Individual | Family Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1770588667 | DR. BARRY L. TULKKI MD Individual | Family Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1679578579 | DR. DEBRA A STRODTHOFF MD Individual | Family Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1194720813 | DR. CRAIG T JOHNSON MD Individual | Family Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1689671331 | DR. EDWARD PAUL HAGEN D.O. Individual | Obstetrics & Gynecology | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1770556227 | DR. JAMES P QUENAN MD Individual | Surgery | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1376620351 | ANDERS E ULLAND M.D. Individual | Surgery | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1043494859 | AMERY REGIONAL MEDICAL CENTER, INC. Organization | Home Infusion | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-0670 |
| 1972742740 | CINDY L O'KEEFE MSW Individual | Social Worker (Clinical) | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1477867745 | AMERY REGIONAL MEDICAL CENTER Organization | Non-Pharmacy Dispensing Site | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1245545540 | JOHNSON DRUG AT ARMC Organization | Non-Pharmacy Dispensing Site | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1083991764 | ST. CROIX ORTHOPAEDICS, P.A. Organization | Durable Medical Equipment & Medical Supplies | 265 GRIFFIN ST E AMERY, WI 54001 (651) 439-8807 |
| 1205105400 | PATRICIA WILLEMAN Individual | Clinical Exercise Physiologist | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-0290 |
| 1063465771 | LYNNELLE RENEE GABRIEL DPM Individual | Podiatrist (Foot & Ankle Surgery) | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-0308 |
| 1841296373 | MS. MARY ANN K SCOGLIO ANP Individual | Clinical Nurse Specialist (Adult Health) | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1306841390 | DR. PAUL F. ELBING MD Individual | Emergency Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1538164520 | DR. DYLAN COE MD Individual | Emergency Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1104825777 | DR. ANTHONY Q. HALL D.C. Individual | Chiropractor | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1124120431 | KEVIN G KLEIN MD Individual | Family Medicine | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
| 1134127319 | THERESA KOHLRUSCH NP Individual | Nurse Practitioner (Pediatrics) | 265 GRIFFIN ST E AMERY, WI 54001 (715) 268-8000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750953790, enumerated in the NPI registry as an "individual" on July 09, 2021
The provider is located at 265 Griffin St E Amery, Wi 54001 and the phone number is (715) 268-8000
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, HealthPartners. 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 $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $95.41 and an average copayment of 23.85. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on July 09, 2021. 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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