Jerome Edward Balbin, M.D.
NPI 1043638638 · Emergency Medicine Physician · Paterson, NJ
Enrolled with Medicare as Practitioner - Emergency Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jerome Edward Balbin, M.D. is a Emergency Medicine Physician provider in Paterson, NJ (NPI 1043638638).
Provider details
- NPI number
- 1043638638
- Entity type
- Individual
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 291566 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
12 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
265 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Emergency Department Visit With High Level of Medical Decision Making99285 | 96 | $184 |
| Emergency Department Visit With Moderate Level of Medical Decision Making99284 | 89 | $126 |
| Critical Care, First 30-74 Minutes99291 | 80 | $224 |
Typical Medicare-allowed amounts for these services range $126–$224 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 5 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Ibuprofen | 61 | 60 |
| Cyclobenzaprine Hcl | 22 | 22 |
| Prednisone | 20 | 18 |
| Famotidine | 15 | 14 |
| Ciprofloxacin Hcl | 13 | 13 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$122 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2014-04-01
- Last updated
- 2025-07-08
- Certified
- 2025-07-08
Frequently asked questions
- What is Jerome Edward Balbin's NPI number?
- Jerome Edward Balbin's National Provider Identifier (NPI) is 1043638638, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jerome Edward Balbin's specialty?
- Jerome Edward Balbin is listed in the NPPES registry with a primary specialty of Emergency Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Jerome Edward Balbin located?
- Jerome Edward Balbin's practice location on file with NPPES is 703 Main Street, Paterson, NJ 07503.
- What is Jerome Edward Balbin's phone number?
- The practice phone number listed in the NPPES registry for Jerome Edward Balbin is (973) 754-2000.
- Does Jerome Edward Balbin accept Medicare?
- Jerome Edward Balbin is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jerome Edward Balbin's NPI active?
- Yes — Jerome Edward Balbin's NPI (1043638638) is active in the NPPES registry as of the last update on 2025-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.