Justin Kyle Balliet (NPI# 1316427651, PAC ID# 9638422371) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1316427651 |
| PAC ID by PECOS | 9638422371 |
| Professional Enrollment ID | I20181029000076 |
| Full Name | Justin Kyle Balliet |
| Organization Legal Name | SUBURBAN PULMONARY MEDICINE, P. C. |
| Address |
1 Bartol Ave Suite 14 Ridley Park PA 19078-2214 |
| Phone Number | 6105211300 |
| Gender | M |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 9234119843 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390180 | CROZER CHESTER MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1 Bartol Ave, Suite 14, Ridley Park, PA 19078-2214 | 6105211300 | SUBURBAN PULMONARY MEDICINE, P. C. |
| Organization Legal Name | SUBURBAN PULMONARY MEDICINE, P. C. |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard E Leyman | Physician Assistant | Suburban Pulmonary Medicine, P. C. | 1 Bartol Ave, Suite 14, Ridley Park, PA 19078-2214 |
| Karen A Lodge | Nurse Practitioner | Suburban Pulmonary Medicine, P. C. | 1 Bartol Ave, Suite 14, Ridley Park, PA 19078-2214 |
| Gerald Anthony Meis | Pulmonary Disease | Suburban Pulmonary Medicine, P. C. | 196 W Sproul Rd, Suite 210, Springfield, PA 19064-2045 |
| Daniel Christopher Dupont | Pulmonary Disease | Suburban Pulmonary Medicine, P. C. | 196 W Sproul Rd, Suite 210, Springfield, PA 19064-2045 |
| Eric Heffelfinger | Pulmonary Disease | Suburban Pulmonary Medicine, P. C. | 196 W Sproul Rd, Suite 210, Springfield, PA 19064-2045 |
| Street Address |
1 BARTOL AVE SUITE 14 |
| City | RIDLEY PARK |
| State | PA |
| Zip | 19078-2214 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeffrey Malumed | Orthopedic Surgery | Premier Orthopaedic and Sports Medicine Associates | 1 Bartol Ave, Suite 100, Ridley Park, PA 19078-2214 |
| Michael J Stewart | Internal Medicine | Prospect Health Access Network Inc | 1 Bartol Ave, Suite 103, Ridley Park, PA 19078-2214 |
| Ifeoma Nwabuzor | Obstetrics/gynecology | Prospect Health Access Network Inc | 1 Bartol Ave, Suite 15, Ridley Park, PA 19078-2214 |
| Richard E Leyman | Physician Assistant | Suburban Pulmonary Medicine, P. C. | 1 Bartol Ave, Suite 14, Ridley Park, PA 19078-2214 |
| Theresa Burcher | Obstetrics/gynecology | Prospect Health Access Network Inc | 1 Bartol Ave, Suite 15, Ridley Park, PA 19078-2214 |
| Karen A Lodge | Nurse Practitioner | Suburban Pulmonary Medicine, P. C. | 1 Bartol Ave, Suite 14, Ridley Park, PA 19078-2214 |
| Nathalie T Degaiffier | Obstetrics/gynecology | Prospect Health Access Network Inc | 1 Bartol Ave, Suite 15, Ridley Park, PA 19078-2214 |
| Armando Mendez | Orthopedic Surgery | Premier Orthopaedic and Sports Medicine Associates | 1 Bartol Ave, Suite 100, Ridley Park, PA 19078-2214 |
| Richard I Zamarin | Orthopedic Surgery | Premier Orthopaedic and Sports Medicine Associates | 1 Bartol Ave, Suite 100, Ridley Park, PA 19078-2214 |
| Michelle Mergenthal | Obstetrics/gynecology | Prospect Health Access Network Inc | 1 Bartol Ave, Suite 15, Ridley Park, PA 19078-2214 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Martin J Bergman | Rheumatology | 23 W Chester Pike, Suite 201, Ridley Park, PA 19078-1629 | |
| Robert Alexander Rhodes | Dermatology | 23 W Chester Pike, Suite 200, Ridley Park, PA 19078-1629 | |
| Emily D Rose | Podiatry | Dr. Lee S Cohen Associates | 642 E Chester Pike, Ridley Park, PA 19078-1701 |
| Loretta F Brown | Addiction Medicine | 648 A E Chester Pike, Ridley Park, PA 19078-1701 | |
| Cory R Hawley | Podiatry | Dr. Lee S Cohen Associates | 642 E Chester Pike, Ridley Park, PA 19078-1701 |
| Lee S Cohen | Podiatry | Dr. Lee S Cohen Associates | 642 E Chester Pike, Ridley Park, PA 19078-1701 |
| Ronald B Phillips | Internal Medicine | 648 A E Chester Pike, Ridley Park, PA 19078-1701 | |
| Marc S Persson | Chiropractic | Perssonal Health Chiropractic LLC | 100 E Chester Pike, Ridley Park, PA 19078-1703 |
| Emily A Swonguer | Chiropractic | Perssonal Health Chiropractic LLC | 100 E Chester Pike, Ridley Park, PA 19078-1703 |
| David R Kalodner | Family Medicine | Internists Associates | 100 E Chester Pike, Ridley Park, PA 19078-1703 |
| Find all physicians in zip 19078 | |||
| City | RIDLEY PARK |
| Zip Code | 19078 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | RIDLEY PARK + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.