David Balaban, MD
NPI 1225035959 · Specialist · Charlottesville, VA
Enrolled with Medicare as Practitioner - Gastroenterology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
David Balaban, MD is a Specialist provider in Charlottesville, VA (NPI 1225035959).
Provider details
- NPI number
- 1225035959
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 0101049501 (VA)
Specialties & taxonomies
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
20 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
1,179 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) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 327 | $88 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 191 | $124 |
| Removal of Polyps Or Growths of Large Bowel Using an Endoscope With Mechanical Snare45385 | 146 | $435 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 134 | $161 |
| Biopsy of Large Bowel Using a Flexible Endoscope45380 | 102 | $307 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 32 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Pantoprazole Sodium | 173 | 43 |
| Omeprazole | 129 | 42 |
| Mesalamine | 95 | 24 |
| Famotidine | 78 | 20 |
| Sodium Chloride/Nahco3/Kcl/Pegbrand: Peg 3350-Electrolyte | 76 | 76 |
| Dicyclomine Hcl | 71 | 39 |
| Linaclotidebrand: Linzess | 64 | 17 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$101 across 4 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
- 2005-07-07
- Last updated
- 2009-01-28
Frequently asked questions
- What is David Balaban's NPI number?
- David Balaban's National Provider Identifier (NPI) is 1225035959, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is David Balaban's specialty?
- David Balaban is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is David Balaban located?
- David Balaban's practice location on file with NPPES is 1139 E High St, Charlottesville, VA 22902-4856.
- What is David Balaban's phone number?
- The practice phone number listed in the NPPES registry for David Balaban is (434) 817-8484.
- Does David Balaban accept Medicare?
- David Balaban is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is David Balaban's NPI active?
- Yes — David Balaban's NPI (1225035959) is active in the NPPES registry as of the last update on 2009-01-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.