Active NPI 1003860172 Individual Practitioner Male Practitioner

Dr. Stanley Richard Balon , MD

Internal Medicine • Woonsocket, RI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Stanley Balon, MD is a certified Internal Medicine practicing in Woonsocket, RI. With approximately 47 years of clinical experience since graduating from Boston University School Of Medicine in 1979, Dr. Balon delivers high-quality medical care to the local community at 20 CUMBERLAND HILL RD UNIT 202.

Dr. Balon is affiliated with Prime Healthcare Services Landmark Llc and accepts 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, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

20 Cumberland Hill Rd Unit 202

Woonsocket, RI 028954854

Telephone 4014884003

Fax 0148844744

Medicare Profile & Education

Medical School

Boston University School Of Medicine

Graduation Year

1979

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Woonsocket, RI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

47 Yrs +20.9 yrs vs City Avg

City Avg: 26.1 Yrs

State Avg: 27.9 Yrs

Regional Practice Density

26 Specialists

Practicing in Woonsocket, RI (1079 Statewide)

Telehealth Adoption Rate

7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

55.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Balon (47 Years) 47 Yrs

Woonsocket Specialty Average (26.1 Years) 26.1 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	165	129	$293.90	$125.54
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	136	106	$32.36	$16.32
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	65	65	$298.00	$129.92
G0009 Administration of pneumococcal vaccine	47	47	$50.00	$32.68
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$209.91	$91.66
93000 Routine ekg using at least 12 leads including interpretation and report	17	17	$34.00	$14.38
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	13	13	$376.00	$163.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	369	200	$292.00	$128.40
99213 Established patient office or other outpatient visit, typically 15 minutes	129	95	$206.00	$92.11
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	114	114	$298.00	$131.28
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	84	84	$376.00	$167.65
G0008 Administration of influenza virus vaccine	57	56	$50.00	$31.37
93000 Routine ekg using at least 12 leads including interpretation and report	42	41	$34.00	$14.76
G0009 Administration of pneumococcal vaccine	21	21	$50.00	$29.88
96127 Assessment of emotional or behavioral problems	21	20	$12.00	$4.85
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	12	12	$128.00	$57.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	348	207	$130.35	$93.74
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	251	158	$196.44	$132.07
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	185	185	$182.31	$135.27
93000 Routine ekg using at least 12 leads including interpretation and report	77	73	$71.27	$14.93
G0008 Administration of influenza virus vaccine	57	57	$40.54	$29.56
90662 Influenza vaccine split virus, preservative free	52	52	$69.59	$59.36
82270 Stool analysis for blood to screen for colon tumors	26	26	$10.00	$4.34
99443 Telephone medical discussion with physician, 21-30 minutes	24	21	$125.00	$122.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	18	16	$77.94	$57.76
99442 Telephone medical discussion with physician, 11-20 minutes	18	17	$100.00	$93.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	435	232	$106.03	$95.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	346	184	$175.00	$135.68
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	220	220	$175.00	$139.13
93000 Routine ekg using at least 12 leads including interpretation and report	121	118	$75.00	$15.61
G0008 Administration of influenza virus vaccine	65	64	$40.00	$17.73
82270 Stool analysis for blood to screen for colon tumors	63	63	$10.00	$4.38
90662 Influenza vaccine split virus, preservative free	60	59	$0.50	$0.50
99442 Telephone medical discussion with physician, 11-20 minutes	38	30	$100.00	$95.51
99443 Telephone medical discussion with physician, 21-30 minutes	25	23	$125.00	$125.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	407	222	$175.00	$113.43
99213 Established patient office or other outpatient visit, typically 15 minutes	357	222	$100.00	$77.53
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	244	244	$175.00	$120.79
93000 Routine ekg using at least 12 leads including interpretation and report	90	83	$75.00	$17.90
99442 Telephone medical discussion with physician, 11-20 minutes	87	68	$90.92	$74.00
82270 Stool analysis for blood to screen for colon tumors	58	58	$10.00	$4.35
G0008 Administration of influenza virus vaccine	53	53	$40.00	$17.62
90662 Influenza vaccine split virus, preservative free	48	48	$1.73	$1.73
99441 Telephone medical discussion with physician, 5-10 minutes	41	35	$65.24	$47.21
G0009 Administration of pneumococcal vaccine	36	36	$40.00	$17.52
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	19	$75.00	$37.27
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	16	16	$6.69	$6.56
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	14	13	$158.57	$13.77
99443 Telephone medical discussion with physician, 21-30 minutes	14	12	$117.86	$105.55

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	556	267	$100.00	$77.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	373	200	$175.00	$112.74
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	259	259	$175.00	$120.24
93000 Routine ekg using at least 12 leads including interpretation and report	142	137	$75.00	$17.77
G0008 Administration of influenza virus vaccine	94	93	$39.58	$17.10
90662 Influenza vaccine split virus, preservative free	64	64	$1.42	$1.33
82270 Stool analysis for blood to screen for colon tumors	47	47	$10.00	$4.29
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	46	14	$70.00	$45.48
G0009 Administration of pneumococcal vaccine	37	37	$40.00	$17.28
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	22	22	$150.00	$147.00
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	17	$75.00	$46.97
90670 Pneumococcal vaccine for injection into muscle	20	20	$0.48	$0.47
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)	16	16	$0.50	$0.49
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	12	12	$55.00	$17.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	543	269	$100.00	$73.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	359	194	$169.57	$108.57
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	236	236	$175.00	$117.63
93000 Routine ekg using at least 12 leads including interpretation and report	188	187	$75.00	$17.22
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	84	18	$70.00	$44.79
G0008 Administration of influenza virus vaccine	66	63	$40.00	$21.32
90662 Influenza vaccine split virus, preservative free	59	57	$0.50	$0.49
82270 Stool analysis for blood to screen for colon tumors	26	26	$10.00	$4.29
G0009 Administration of pneumococcal vaccine	24	24	$40.00	$21.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	21	19	$75.00	$44.45
90670 Pneumococcal vaccine for injection into muscle	18	18	$0.50	$0.49
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	16	11	$150.00	$91.59
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	14	14	$150.00	$147.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	513	255	$100.00	$72.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	357	199	$150.00	$107.23
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	229	229	$175.00	$115.75
93000 Routine ekg using at least 12 leads including interpretation and report	201	195	$75.00	$17.07
G0008 Administration of influenza virus vaccine	102	100	$40.00	$26.42
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	91	22	$70.00	$44.44
90662 Influenza vaccine split virus, preservative free	77	76	$1.27	$1.11
G0009 Administration of pneumococcal vaccine	61	61	$40.00	$26.42
90670 Pneumococcal vaccine for injection into muscle	52	52	$0.50	$0.49
99231 Follow-up hospital inpatient care per day, typically 15 minutes	44	21	$75.00	$38.98
Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)	23	23	$4.81	$4.09
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	20	18	$75.00	$43.75
82270 Stool analysis for blood to screen for colon tumors	17	17	$10.00	$4.37
99238 Hospital discharge day management, 30 minutes or less	14	14	$100.00	$72.30
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$153.85	$149.86
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	12	12	$150.00	$90.81

Medical Specialties & State Licenses

CMS Verified: 2024-09-20

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License RI 5801

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.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License RI 05801

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

9001130 (RI)

Hospital & Practice Group Affiliations

Prime Healthcare Services Landmark Llc

206 Cass Ave, Woonsocket, RI 028954712

Phone: 4017671595

Prime Healthcare Services Landmark Llc

115 Cass Ave, Woonsocket, RI 028954705

Prime Healthcare Services Landmark Llc

255 Cass Ave, Woonsocket, RI 028954705

Phone: 4017694100

Prime Healthcare Services Landmark Llc

115 Cass Ave, Woonsocket, RI 028954705

Phone: 4015975070

Career & Practice History Timeline

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

9 Historical Events

📍

Updated Practice Location September 20, 2024

Registered at 20 CUMBERLAND HILL RD UNIT 202, WOONSOCKET, RI 028954854 (Tel: 4014884003)

📍

Updated Business Mailing Address September 20, 2024

Registered at 20 CUMBERLAND HILL RD UNIT 202, WOONSOCKET, RI 028954854 (Tel: 4014884003)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2024

Internal Medicine (License #05801 in RI)

✅

NPI Profile Active June 19, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location June 19, 2008

Registered at 175 NATE WHIPPLE HWY, SUITE 204, CUMBERLAND, RI 028641416 (Tel: 4016581744)

📍

Updated Business Mailing Address June 19, 2008

Registered at 175 NATE WHIPPLE HWY, SUITE 204, CUMBERLAND, RI 028641416 (Tel: 4016581744)

👤

Provider Name / Credentials Updated June 19, 2008

Recorded as STANLEY BALON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 19, 2008

Internal Medicine (License #5801 in RI)

🟢

Initial NPI Registration & Enumeration May 21, 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: 1003860172

Entity Type:

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

Enumeration Date: May 21, 2006

Last Update: September 20, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

20 Cumberland Hill Rd Unit 202

Woonsocket, RI 028954854

Phone: 4014884003

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.