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Physician Compare National (NPI:1417236902)

HEALTHCARE PROVIDER: ZACHARY E BALLENGER MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1417236902
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5799921227
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20170830000790
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BALLENGER
Individual professional last name
Provider First Name ZACHARY
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2010
Individual professional's medical school graduation year
Primary Specialty DIAGNOSTIC RADIOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name LUBBOCK DIAGNOSTIC RADIOLOGY, L.L.P.
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 4183521859
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 22
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 42121 US
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 70
Group Practice or individual's line 2 address
City PORTALES
Group Practice or individual's city
State NM
Group Practice or individual's state
Zip Code 881309054
Group Practice or individual's zip code (9 digits when available)
Phone Number 8067922767
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 450040
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 COVENANT MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 450686
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 UNIVERSITY MEDICAL CENTER
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 450539
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 COVENANT HOSPITAL PLAINVIEW
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 453306
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 COVENANT CHILDRENS HOSPITAL
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 450755
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 COVENANT HOSPITAL LEVELLAND
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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