Luis Balbuena, MD
NPI 1649254749 · Otolaryngology Physician · Marshall, TX
Enrolled with Medicare as Practitioner - Otolaryngology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Luis Balbuena, MD is a Otolaryngology Physician provider in Marshall, TX (NPI 1649254749).
Provider details
- NPI number
- 1649254749
- Entity type
- Individual
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- J5538 (TX)
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
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
1,021 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 | 305 | $88 |
| New Patient Office Or Other Outpatient Visit With Low Level of Medical Decision Making, If Using Time, 30 Minutes Or More99203 | 132 | $109 |
| Test to Assess Middle Ear Function92567 | 103 | $16 |
| Removal of Impacted Ear Wax69210 | 97 | $45 |
| Diagnostic Exam of Voice Box Using a Flexible Endoscope31575 | 78 | $125 |
| Comprehensive Hearing and Speech Recognition Test92557 | 74 | $36 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 20 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Fluticasone Propionate | 357 | 145 |
| Pantoprazole Sodium | 183 | 50 |
| Ipratropium Bromide | 126 | 57 |
| Cefdinir | 61 | 59 |
| Famotidine | 59 | 15 |
| Levocetirizine Dihydrochloride | 54 | 22 |
| Clotrimazole | 45 | 24 |
| Meclizine Hcl | 39 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$42 across 2 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
- 2005-12-01
- Last updated
- 2011-06-30
Frequently asked questions
- What is Luis Balbuena's NPI number?
- Luis Balbuena's National Provider Identifier (NPI) is 1649254749, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Luis Balbuena's specialty?
- Luis Balbuena is listed in the NPPES registry with a primary specialty of Otolaryngology Physician (Allopathic & Osteopathic Physicians).
- Where is Luis Balbuena located?
- Luis Balbuena's practice location on file with NPPES is 703 S Washington Ave, Marshall, TX 75670-5337.
- What is Luis Balbuena's phone number?
- The practice phone number listed in the NPPES registry for Luis Balbuena is (903) 927-6880.
- Does Luis Balbuena accept Medicare?
- Luis Balbuena is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Luis Balbuena's NPI active?
- Yes — Luis Balbuena's NPI (1649254749) is active in the NPPES registry as of the last update on 2011-06-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.