Dr Ildiko Balla, PHD is a medicare enrolled "Psychologist - Clinical" provider in Fort Worth, Texas. Her current practice location is
4200 S Hulen St Ste 658, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at
(682) 597-3933.
Dr Ildiko Balla is licensed to practice in Texas (license number 32879) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1437368446.
Healthcare Provider's Profile
| Full Name | Dr Ildiko Balla |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 4200 S Hulen St Ste 658, Fort Worth, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1437368446
- Provider Enumeration Date: 05/22/2007
- Last Update Date: 03/07/2012
Medicare PECOS Information:
- PECOS PAC ID: 2769643527
- Enrollment ID: I20120423000325
Medical Identifiers
Medical identifiers for Dr Ildiko Balla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437368446 | NPI | - | NPPES |
| 028537102 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 16553 (Texas) | Secondary |
| 103TC1900X | Psychologist - Counseling | 32879 (Texas) | Secondary |
| 103TC0700X | Psychologist - Clinical | 32879 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Ildiko Balla allows following entities to bill medicare on her behalf.
| Entity Name | Deer Oaks Geriatric Services P C |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134169287
PECOS PAC ID: 9234034075
Enrollment ID: O20031204000440 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Ildiko Balla is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Ildiko Balla, PHD
2136 Cliff Park,
Fort Worth, TX 76134-1016
Ph: (682) 597-3933 | Dr Ildiko Balla, PHD
4200 S Hulen St Ste 658,
Fort Worth, TX 76109-4987
Ph: (682) 597-3933 |
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