Matthew Balderston, M.D.
NPI 1316386394 · Family Medicine Physician · Virginia Beach, VA
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Matthew Balderston, M.D. is a Family Medicine Physician provider in Virginia Beach, VA (NPI 1316386394).
Provider details
- NPI number
- 1316386394
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 28301 (NE)
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
13 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
4,477 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 | 543 | $124 |
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 449 | $16 |
| Insertion of Needle Into Vein for Collection of Blood Sample36415 | 391 | $9 |
| Blood Test, Comprehensive Group of Blood Chemicals80053 | 316 | $10 |
| Annual Wellness Visit, Includes a Personalized Prevention Plan of Service (pps), Subsequent VisitG0439 | 311 | $125 |
| Annual Depression Screening, 5 to 15 Minutes |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 116 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Atorvastatin Calcium | 371 | 110 |
| Amlodipine Besylate | 352 | 103 |
| Lisinopril | 265 | 80 |
| Rosuvastatin Calcium | 265 | 80 |
| Simvastatin | 230 | 70 |
| Levothyroxine Sodium | 226 | 65 |
| Losartan Potassium |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$1,027 across 53 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
Additional practice locations (1)
- 307 Boatner RdSuite 114Eglin Afb, FL 32542-1302Phone: (850) 883-8600
Registry dates
- Enumerated
- 2013-06-22
- Last updated
- 2024-10-21
- Certified
- 2024-10-21
Frequently asked questions
- What is Matthew Balderston's NPI number?
- Matthew Balderston's National Provider Identifier (NPI) is 1316386394, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Matthew Balderston's specialty?
- Matthew Balderston is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Matthew Balderston located?
- Matthew Balderston's practice location on file with NPPES is 351 Edwin Dr Ste 102, Virginia Beach, VA 23462-4559.
- What is Matthew Balderston's phone number?
- The practice phone number listed in the NPPES registry for Matthew Balderston is (757) 499-5550.
- Does Matthew Balderston accept Medicare?
- Matthew Balderston is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Matthew Balderston's NPI active?
- Yes — Matthew Balderston's NPI (1316386394) is active in the NPPES registry as of the last update on 2024-10-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.