Erika Balbuena
NPI 1326724881 · Family Nurse Practitioner · Chicago, IL
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Erika Balbuena is a Family Nurse Practitioner provider in Chicago, IL (NPI 1326724881).
Provider details
- NPI number
- 1326724881
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
3 yrs in NPPES registry
- Profile completeness25% of score
83% of core fields populated
- Practice footprint15% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)25% of score
614 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 | 183 | $111 |
| Annual Wellness Visit, Includes a Personalized Prevention Plan of Service (pps), Subsequent VisitG0439 | 56 | $113 |
| Advance Care Planning, First 30 Minutes99497 | 50 | $72 |
| Urinalysis, Manual Test81002 | 41 | $3 |
| Annual Depression Screening, 5 to 15 MinutesG0444 | 40 | $17 |
| Administration of Influenza Virus VaccineG0008 | 32 | $32 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 10 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Atorvastatin Calcium | 52 | 21 |
| Metformin Hcl | 20 | — |
| Metoprolol Succinate | 18 | — |
| Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass | 17 | 16 |
| Losartan Potassium | 15 | — |
| Albuterol Sulfatebrand: Albuterol Sulfate Hfa | 15 | — |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$1,757 across 73 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)
- 3924 N Grant StWestmont, IL 60559-1106Phone: (708) 835-7420
Registry dates
- Enumerated
- 2023-06-27
- Last updated
- 2023-10-12
- Certified
- 2023-10-12
Frequently asked questions
- What is Erika Balbuena's NPI number?
- Erika Balbuena's National Provider Identifier (NPI) is 1326724881, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Erika Balbuena's specialty?
- Erika Balbuena is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Erika Balbuena located?
- Erika Balbuena's practice location on file with NPPES is 6918 W Archer Ave, Chicago, IL 60638-2337.
- What is Erika Balbuena's phone number?
- The practice phone number listed in the NPPES registry for Erika Balbuena is (773) 667-3508.
- Does Erika Balbuena accept Medicare?
- Erika Balbuena is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Erika Balbuena's NPI active?
- Yes — Erika Balbuena's NPI (1326724881) is active in the NPPES registry as of the last update on 2023-10-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.