Paul Balash, M.D.
NPI 1073741625 · Surgery Physician · Oak Lawn, IL
Enrolled with Medicare as Practitioner - General Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Paul Balash, M.D. is a Surgery Physician provider in Oak Lawn, IL (NPI 1073741625).
Provider details
- NPI number
- 1073741625
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 036129228 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
17 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
397 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) |
|---|---|---|
| Subsequent Hospital Care With Straightforward Or Low Level of Medical Decision Making, Per Day, If Using Time, at Least 25 Minutes99231 | 115 | $51 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 88 | $134 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 72 | $173 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 66 | $91 |
| Insertion of Needle Into Vein for Collection of Blood Sample36415 | 23 | $9 |
| Repair of Groin Hernia Using an Endoscope |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 3 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 107 | 93 |
| Metoclopramide Hcl | 13 | 12 |
| Sulfamethoxazole/Trimethoprimbrand: Sulfamethoxazole-Trimethoprim | 12 | 12 |
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.
$36,903 across 37 records (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
- 2009-06-22
- Last updated
- 2021-12-10
- Certified
- 2021-12-10
Frequently asked questions
- What is Paul Balash's NPI number?
- Paul Balash's National Provider Identifier (NPI) is 1073741625, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Paul Balash's specialty?
- Paul Balash is listed in the NPPES registry with a primary specialty of Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Paul Balash located?
- Paul Balash's practice location on file with NPPES is 4400 W 95th St Ste 413, Oak Lawn, IL 60453-2662.
- What is Paul Balash's phone number?
- The practice phone number listed in the NPPES registry for Paul Balash is (708) 346-4055.
- Does Paul Balash accept Medicare?
- Paul Balash is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Paul Balash's NPI active?
- Yes — Paul Balash's NPI (1073741625) is active in the NPPES registry as of the last update on 2021-12-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.