ASHFAQ S. BALLA (NPI# 1740228220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740228220 |
| Entity Type | Individual |
| Full Name | ASHFAQ S. BALLA |
| Credential | MD |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-5348 |
| Practice Telephone | 5088563155 |
| Practice Fax Number | 5088563111 |
| Mailing Telephone | 8002258885 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
242372 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110084568A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 188 Worcester Providence Tpke, Sutton, MA 01590 | 5087559535 | 5087551006 |
| 85 Prescott St, Worcester, MA 01605 | 5087559535 | 5087551006 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124571948 | Adil Ghaffar | Internal Medicine | 123 Summer St, Worcester, MA 01608-1216 | 2016-07-28 |
| 1316321326 | Amar P. Pandit | Internal Medicine | 55 Lake Ave N, Worcester, MA 01655-0002 | 2015-07-20 |
| 1548643752 | Nishanth Girija Kumar | Internal Medicine | 123 Summer St, Worcester, MA 01608-1216 | 2015-07-07 |
| 1053548321 | Matthew Adam Niemi | Internal Medicine | 55 Lake Ave N, Department of Nephrology, Worcester, MA 01655-0002 | 2009-06-15 |
| 1497990014 | Nicholas T Quarshie | Internal Medicine | 55 Lake Ave N, Worcester, MA 01655 | 2008-12-10 |
| 1396906525 | Ajay Kher | Internal Medicine | 55 Lake Ave N, Dept. of Nephrology, Worcester, MA 01655-0002 | 2008-06-20 |
| 1992854707 | Konstantin Abramov | Internal Medicine | 55 Lake Ave N, Worcester, MA 01655-0002 | 2007-01-10 |
| 1275556912 | Eric S. IIda | Internal Medicine | 55 Lake Ave N, Renal Division, Worcester, MA 01655-0002 | 2006-07-25 |
| 1699790295 | Kenneth A Bodziak | Internal Medicine | 55 Lake Ave N, Transplant Nephrology, Worcester, MA 01655-0002 | 2006-07-13 |
| 1578534327 | Dagmar Klinger | Internal Medicine | 55 Lake Ave N, Department of Renal Medicine, Worcester, MA 01655-0002 | 2006-01-30 |
| Find all providers in WORCESTER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.