Active NPI 1598773483 Individual Practitioner Male Practitioner

Dr. Bernard H Ballou , MD

Internal Medicine • Gainesville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Bernard Ballou, MD is a certified Internal Medicine practicing in Gainesville, FL. With approximately 41 years of clinical experience since graduating from University Of Miami, Lm Miller School Of Medicine in 1985, Dr. Ballou delivers high-quality medical care to the local community at 3720 NW 83RD ST.

Dr. Ballou is affiliated with Lake Area Physical Therapy Inc. and does not directly accept Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's, physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3720 Nw 83rd St

Gainesville, FL 326065603

Telephone 3523363050

Associated Practice Facility / Clinic

🏢 James J Nelson Md Pa Facility NPI 1881650836

Medicare Profile & Education

Medical School

University Of Miami, Lm Miller School Of Medicine

Graduation Year

1985

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Gainesville, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

41 Yrs +22.6 yrs vs City Avg

City Avg: 18.4 Yrs

State Avg: 26.5 Yrs

Regional Practice Density

296 Specialists

Practicing in Gainesville, FL (10650 Statewide)

Telehealth Adoption Rate

12.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

26.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ballou (41 Years) 41 Yrs

Gainesville Specialty Average (18.4 Years) 18.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	432	249	$89.96	$65.16
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	383	131	$20.00	$16.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	327	201	$120.00	$95.67
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	299	270	$180.00	$142.43
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	49	41	$90.00	$52.05
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	46	24	$70.00	$40.50
99495 Transitional care management services for problem of at least moderate complexity	36	33	$180.00	$134.19
99496 Transitional care management services for problem of high complexity	29	26	$250.00	$186.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	524	285	$90.00	$65.71
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	303	289	$180.00	$142.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	262	168	$120.00	$96.98
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	65	52	$90.00	$50.77
99496 Transitional care management services for problem of high complexity	41	37	$250.00	$185.36
99495 Transitional care management services for problem of at least moderate complexity	37	32	$180.00	$138.55
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	29	15	$70.00	$40.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$140.00	$83.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	524	281	$88.57	$67.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	339	220	$120.00	$98.11
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	326	303	$176.35	$145.52
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	59	52	$95.76	$52.11
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	51	25	$70.00	$40.28
99496 Transitional care management services for problem of high complexity	32	29	$250.00	$194.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$197.10	$137.60
99495 Transitional care management services for problem of at least moderate complexity	26	25	$180.00	$143.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	496	262	$88.00	$68.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	417	238	$113.45	$101.29
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	320	291	$175.00	$149.06
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	63	34	$70.00	$40.81
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	60	48	$100.00	$52.66
99496 Transitional care management services for problem of high complexity	53	44	$250.00	$198.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$197.00	$139.26
99495 Transitional care management services for problem of at least moderate complexity	28	28	$180.00	$145.81
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	19	19	$259.00	$188.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	14	14	$138.00	$85.69
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	12	12	$35.00	$32.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	794	374	$88.00	$52.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	342	215	$110.00	$81.16
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	276	255	$175.00	$115.00
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	64	58	$100.00	$53.86
99496 Transitional care management services for problem of high complexity	53	47	$250.00	$167.10
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	49	28	$70.00	$41.10
99495 Transitional care management services for problem of at least moderate complexity	35	34	$180.00	$126.46
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$197.00	$133.91
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	13	13	$259.00	$175.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,071	445	$88.00	$51.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	398	252	$110.00	$78.73
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	267	256	$175.00	$111.69
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	82	82	$197.00	$130.41
99496 Transitional care management services for problem of high complexity	68	56	$250.00	$160.37
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	54	43	$100.00	$52.54
99495 Transitional care management services for problem of at least moderate complexity	52	46	$180.00	$110.52
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	52	52	$138.00	$77.52
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	32	22	$70.00	$40.38
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	12	12	$259.00	$170.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,127	437	$88.00	$51.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	325	206	$110.00	$78.80
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	263	250	$175.00	$111.52
99496 Transitional care management services for problem of high complexity	66	56	$250.00	$160.86
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	57	47	$100.00	$53.12
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	40	21	$70.00	$41.01
99495 Transitional care management services for problem of at least moderate complexity	38	34	$180.00	$110.79
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	32	32	$197.00	$131.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	31	31	$138.00	$77.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	1,007	379	$88.00	$51.09
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	501	96	$98.00	$72.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	274	175	$110.00	$78.08
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	207	205	$175.00	$111.68
99239 Hospital discharge day management, more than 30 minutes	132	94	$169.00	$107.22
99496 Transitional care management services for problem of high complexity	54	51	$250.00	$160.13
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	48	43	$100.00	$53.03
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	46	22	$73.13	$40.64
99495 Transitional care management services for problem of at least moderate complexity	39	35	$180.00	$110.42
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	24	21	$232.00	$203.69
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	20	20	$200.10	$130.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	17	$58.00	$25.61
93010 Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only	12	11	$38.00	$8.52

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License FL ME0049070

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

048165300 (FL)

Hospital & Practice Group Affiliations

Lake Area Physical Therapy Inc.

Po Box, Melrose, FL 326661099

Lake Area Physical Therapy Inc.

Po Box, Melrose, FL 326661099

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners

Dr. James Nelson , MD

Internal Medicine - Cardiovascular Disease

NPI 1053592162

Doctor of Medicine (M.D.)

Dr. Cynthia Preston , MD

Internal Medicine

NPI 1104929348

Doctor of Medicine (M.D.)

Dr. Nannette Hoffman , MD

Internal Medicine - Geriatric Medicine

NPI 1568406734

Doctor of Medicine (M.D.)

Teresa Barr , ARNP

Nurse Practitioner - Adult Health

NPI 1740418565

Advanced Registered Nurse Practitioner

Eyrone Bush , MSN, APRN, FNP-BC

Nurse Practitioner - Family

NPI 1790382893

Master of Science in Nursing, Advanced Practice Registered Nurse, Family Nurse Practitioner (Board Certified)

Dr. Julie Zhu , MD

Internal Medicine - Geriatric Medicine

NPI 1871506212

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active May 05, 2009

NPI status registered as active in NPPES database

📍

Updated Practice Location May 05, 2009

Registered at 3720 NW 83RD ST, GAINESVILLE, FL 326065603 (Tel: 3523363050)

📍

Updated Business Mailing Address May 05, 2009

Registered at PO BOX 358720, GAINESVILLE, FL 326358720 (Tel: 3523316410)

👤

Provider Name / Credentials Updated May 05, 2009

Recorded as BERNARD BALLOU, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 05, 2009

Internal Medicine (License #ME0049070 in FL)

🟢

Initial NPI Registration & Enumeration August 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598773483

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 04, 2006

Last Update: May 05, 2009

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Po Box 358720

Gainesville, FL 326358720

Phone: 3523316410

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.