Active NPI 1265640411 Individual Practitioner Male Practitioner

Dr. Andrew Peter Balbaugh , MD

Internal Medicine • Georgetown, KY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Andrew Balbaugh, MD is a certified Internal Medicine practicing in Georgetown, KY. With approximately 23 years of clinical experience since graduating from Northeastern Ohio University College Of Medicine in 2003, Dr. Balbaugh delivers high-quality medical care to the local community at 196 BEVINS LN.

Dr. Balbaugh is affiliated with Kentucky Mso Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, administration of influenza virus vaccine. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

196 Bevins Ln
Suite F

Georgetown, KY 403248534

Telephone 5028632818

Fax 5028632764

Associated Practice Facility / Clinic

🏢 Bluegrass Pediatrics And Internal Medicine, Pllc Facility NPI 1427229707

Medicare Profile & Education

Medical School

Northeastern Ohio University College Of Medicine

Graduation Year

2003

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Georgetown, KY

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

23 Yrs -2.7 yrs vs City Avg

City Avg: 25.7 Yrs

State Avg: 26.6 Yrs

Regional Practice Density

12 Specialists

Practicing in Georgetown, KY (1608 Statewide)

Telehealth Adoption Rate

16.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

46.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Balbaugh (23 Years) 23 Yrs

Georgetown Specialty Average (25.7 Years) 25.7 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	85	44	$151.00	$83.63
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	25	25	$220.58	$119.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	13	$227.00	$117.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	100	50	$151.00	$83.74
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	28	28	$220.58	$119.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	14	$227.00	$118.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	89	53	$151.00	$84.95
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	22	$227.00	$116.42
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	24	24	$220.58	$121.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	126	56	$151.00	$84.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	40	27	$227.00	$113.55
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	15	15	$220.58	$124.72
G0008 Administration of influenza virus vaccine	11	11	$16.00	$15.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	151	67	$151.00	$69.85
81000 Manual urinalysis test with examination using microscope, non-automated	14	11	$15.29	$3.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	13	13	$227.00	$96.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	191	88	$155.71	$68.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	21	$227.00	$101.89
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	20	20	$273.79	$160.40
G0008 Administration of influenza virus vaccine	13	13	$16.00	$15.31
90653 Vaccine for influenza for injection into muscle	11	11	$102.00	$58.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	214	94	$151.00	$64.91
G0008 Administration of influenza virus vaccine	15	15	$16.00	$15.68
90653 Vaccine for influenza for injection into muscle	14	14	$102.00	$53.58
81000 Manual urinalysis test with examination using microscope, non-automated	13	11	$15.00	$3.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	196	92	$151.00	$68.00
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	12	$227.00	$100.22
G0008 Administration of influenza virus vaccine	12	12	$16.00	$15.68
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	12	12	$45.00	$18.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$225.00	$100.47

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License KY 41057

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.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License KY 41057

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

7100011650 (KY)

Hospital & Practice Group Affiliations

Kentucky Mso Llc

1138 Lexington Rd, Georgetown, KY 403249673

Phone: 5025702324

Kentucky Mso Llc

175 Hospital Dr, Georgetown, KY 40324

Phone: 5025702324

Practice Associates & Co-Workers

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

3 Associated Practitioners

Dr. Joel Knight , MD

Internal Medicine

NPI 1235292343

Doctor of Medicine (M.D.)

Dr. Mobolanle Elder , MD

Pediatrics

NPI 1245896224

Doctor of Medicine (M.D.)

Dr. Martin Castillo Liranzo , MD

Pediatrics

NPI 1679837181

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

11 Historical Events

✅

NPI Profile Active February 11, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location February 11, 2017

Registered at 196 BEVINS LN, SUITE F, GEORGETOWN, KY 403248534 (Tel: 5028632818)

📍

Updated Business Mailing Address February 11, 2017

Registered at 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 370275098 (Tel: 6159207906)

👤

Provider Name / Credentials Updated February 11, 2017

Recorded as ANDREW BALBAUGH, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2017

Internal Medicine (License #41057 in KY)

✅

NPI Profile Active October 02, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location October 02, 2015

Registered at 196 BEVINS LN F, GEORGETOWN, KY 403248534 (Tel: 5028632818)

📍

Updated Business Mailing Address October 02, 2015

Registered at 196 BEVINS LN F, GEORGETOWN, KY 403248534 (Tel: 5028632818)

👤

Provider Name / Credentials Updated October 02, 2015

Recorded as ANDREW BALBAUGH, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2015

Internal Medicine (License #41057 in KY)

🟢

Initial NPI Registration & Enumeration May 20, 2007

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: 1265640411

Entity Type:

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

Enumeration Date: May 20, 2007

Last Update: February 11, 2017

Sole Proprietor: No

Update or Correct Profile

Mailing Address

330 Seven Springs Way

Brentwood, TN 370275098

Phone: 6159207906

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.