Nicholas Ballay, MD
NPI 1295093052 · Surgery Physician · Athens, TN
Enrolled with Medicare as Practitioner - General Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Nicholas Ballay, MD is a Surgery Physician provider in Athens, TN (NPI 1295093052).
Provider details
- NPI number
- 1295093052
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- MD0000056407 (TN)
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
14 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
530 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 Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 160 | $117 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 117 | $83 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 69 | $153 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 45 | $73 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 38 | $160 |
| Removal of Polyps Or Growths of Large Bowel Using a Flexible Endoscope With Electrical Cautery |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 15 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Pantoprazole Sodium | 100 | 41 |
| Omeprazole | 98 | 26 |
| Ondansetron Hcl | 84 | 75 |
| Oxycodone Hcl/Acetaminophenbrand: Oxycodone-Acetaminophen | 80 | 65 |
| Promethazine Hcl | 66 | 61 |
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 64 | 58 |
| Lansoprazole |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$17 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
Additional practice locations (1)
- 304 Wright St Fl 3Sweetwater, TN 37874-1181Phone: (423) 252-0288
Registry dates
- Enumerated
- 2012-04-30
- Last updated
- 2023-07-19
- Certified
- 2023-07-19
Frequently asked questions
- What is Nicholas Ballay's NPI number?
- Nicholas Ballay's National Provider Identifier (NPI) is 1295093052, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Nicholas Ballay's specialty?
- Nicholas Ballay is listed in the NPPES registry with a primary specialty of Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Nicholas Ballay located?
- Nicholas Ballay's practice location on file with NPPES is 719 Cook Dr, Athens, TN 37303.
- What is Nicholas Ballay's phone number?
- The practice phone number listed in the NPPES registry for Nicholas Ballay is (423) 745-2344.
- Does Nicholas Ballay accept Medicare?
- Nicholas Ballay is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Nicholas Ballay's NPI active?
- Yes — Nicholas Ballay's NPI (1295093052) is active in the NPPES registry as of the last update on 2023-07-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.