JOHN R BALFANZ, MD — NPI 1669452561 (Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) in ST PAUL, MN)

CMS-1500 Box 24J / 33a • NPI

1669452561

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

208000000X (CMS 37)

Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)

Box 32 Service Location & ZIP+4

233 GRAND AVE, ST PAUL, MN, 55102

Official NPPES Practice Location

Practice Phone & Referral Fax

(651) 227-7806

Fax: (651) 256-6707

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1669452561 (JOHN R BALFANZ, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Medicare Part B

✓ Eligible

DMEPOS Ordering

✓ Eligible

Home Health (HHA)

✓ Eligible

Power Mobility

✓ Eligible

Hospice Referring

✓ Eligible

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1669452561` (NPI-1 Individual Practitioner)
Provider / Legal Name	JOHN R BALFANZ, MD
Plain-English Specialty	Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: `208000000X` (Pediatrics)
Certifying / Licensing Body	American Board of Pediatrics (ABP)
Practice Location Address	233 GRAND AVE, ST PAUL, MN, 55102
Practice Telephone / Fax	Tel: (651) 227-7806 \| Fax: (651) 256-6707
Administrative Mailing Address	ESSENTIA HEALTH DULUTH CLINIC - MCL2CRED, DULUTH, MN, 55805-1951
Enumeration & Last Sync	Enumerated: 2006-01-18 \| CMS Record Updated: 2016-10-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

233 GRAND AVE, ST PAUL, MN, 55102

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Plain-English Taxonomy & CMS Crosswalk (208000000X)

What Does Taxonomy Code 208000000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208000000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 37 (Physician/Pediatric Medicine)
Certifying / Accrediting Authority: American Board of Pediatrics (ABP)
Clinical Scope: Newborn jaundice screening, routine childhood vaccinations, developmental milestones, pediatric fevers, ear infections, asthma, or acute gastroenteritis.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JOHN R BALFANZ, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
Pediatric Asthma Nebulization & Spirometry Evaluation

Common Therapeutic Classes:

Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208000000X` — Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: MN \| License: `20262` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JOHN R BALFANZ, MD (NPI #1669452561)

CMS Medicare Order & Referring PECOS Eligibility

Official CMS NPPES Credential & Practice Profile

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

What Does Taxonomy Code 208000000X Mean?

Standard Scope of Care (JOHN R BALFANZ, MD)

All Registered NUCC Taxonomies & State Licenses