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WESAM BALLOUK MD NPI 1841291762


NPI Information

NPI: 1841291762
Provider Name: WESAM BALLOUK, MD
Classification: Specialist - 174400000X
Entity Type: Individual
Organization: THE KIDNEY GROUP OF MEMPHIS, PLLC

PECOS Registration: Yes

Address:
2225 UNION AVE
STE 100
MEMPHIS, TN
ZIP 38104
Phone: (901) 726-1161
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Wesam Ballouk, MD is a specialist in Memphis, TN with 28 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Wesam Ballouk, MD NPI is 1841291762. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2225 UNION AVE
STE 100
MEMPHIS, TN
ZIP 38104-316
Phone: (901) 726-1161
Fax: (901) 726-0161

The NPI 1841291762 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services (2-3 physician visits per month), patient 20 years of age and older (HCPCS:90961)
  • Dialysis services (4 or more physician visits per month), patient 20 years of age and older (HCPCS:90960)
  • Hemodialysis procedure with one physician evaluation (HCPCS:90935)
  • Dialysis services (1 physician visit per month), patient 20 years of age and older (HCPCS:90962)
  • Home dialysis services per month, patient 20 years of age or older (HCPCS:90966)

The enumeration date for this NPI number is 8/2/2005 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistMD0037027TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1I24044MEDICARE UPINTENNESSEE
23326942MEDICARE ID-TYPE UNSPECIFIEDTENNESSEE
33326941MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.