Dr. Nancy Balkon , PhD, NP, FAANP
Nurse Practitioner โข Smithtown, NY
267 E Main St Bldg C
Smithtown, NY 117872847
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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Dr. Nancy Balkon is listed in NPPES under Nurse Practitioner.
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NPI assigned on April 26, 2010; this date does not establish years in practice.
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Published CMS data list 95 Original Medicare Part B services in 2023.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2023. Published rows only; this is not a quality measure.
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Published Part B service records, 2023:
- 99307 โ Subsequent nursing facility care with straightforward level of medical decision making, per day: 52 service units.
- 99308 โ Subsequent nursing facility care with straightforward level of medical decision making, per day: 29 service units.
- 99212 โ Established patient outpatient office visit: 14 service units.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2023. Units differ by code; these are not visits or a measure of quality.
CPTยฎ only copyright 2022 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2023). CPT notice
See the full table ยท Guide: How to read Medicare Part B data
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Published CMS data list 884 Medicare Part D prescriptions, including refills, in 2021.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2021. Published rows only; this is not a quality measure.
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Published Part D records, 2021:
- Atorvastatin Calcium โ 86 prescription fills, including refills.
- Lisinopril โ 80 prescription fills, including refills.
- Simvastatin โ 45 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2021. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 37 records in the table ยท Guide: How to read Medicare Part D prescriber data
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Medicare Part B services went from 136 in 2020 to 95 in 2023.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2020โ2023.
Practice Location & Contact Primary Location
267 E Main St Bldg C
Smithtown, NY 117872847
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Nurse Practitioner: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare-allowed amount
About $4,986 in 2023
The total amount Medicare approved for these services in 2023. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2023.
Paid by Medicare
About $3,978 in 2023
The part of the Medicare-allowed amount that Medicare itself paid in 2023, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners โ by Provider and Service, 2023.
30-day fills
2,058 standardized 30-day fills in 2021
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$42,250 in 2021
The total cost of these prescriptions in 2021, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers โ by Provider and Drug, 2021.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2021โ2025.
NPI first issued
2010
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, โDoes your provider accept Medicare as full payment?โ
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Can order Medicare-covered services
CMS lists Dr. Balkon as eligible to order or refer durable medical equipment (DME) for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Smithtown and New York
Billing and prescribing volume is not a quality rating.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Dr. Balkon are from 2023.
Medicare Part D
Comparisons use 2024 data. The latest CMS data for Dr. Balkon are from 2021.
14 active clinicians are listed under Nurse Practitioner with a practice address in Smithtown, NY (3,102 in New York).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Smithtown
7.1% of these 14 clinicians have the CMS telehealth indicator.
57.1% of these 14 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 30% from 136 in 2020 to 95 in 2023.
- 2020: 136
- 2021: 324
- 2023: 95
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Medicare-allowed amount
Medicare-allowed amount decreased 47% from $9,495 in 2020 to $4,986 in 2023.
- 2020: $9,495
- 2021: $32,179
- 2023: $4,986
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Paid by Medicare
Paid by Medicare decreased 45% from $7,261 in 2020 to $3,978 in 2023.
- 2020: $7,261
- 2021: $21,730
- 2023: $3,978
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Medicare Part D prescriptions
Medicare Part D prescriptions increased 482% from 152 in 2020 to 884 in 2021.
- 2020: 152
- 2021: 884
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30-day fills
30-day fills increased 507% from 339 in 2020 to 2,058 in 2021.
- 2020: 339
- 2021: 2,058
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Part D drug cost
Part D drug cost increased 1697% from $2,351 in 2020 to $42,250 in 2021.
- 2020: $2,351
- 2021: $42,250
Sources: CMS Medicare Physician & Other Practitioners (2023), CMS Medicare Part D Prescribers (2021), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo ยท Report an error.
Performed Procedures & Service Volume
CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2019โ2022 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ by Provider and Service data, 2020โ2023; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99307
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes
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52 | 24 | $120.00 | $39.01 |
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99308
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more
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29 | 19 | $178.62 | $74.23 |
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99212
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
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14 | 11 | $150.00 | $57.48 |
Source: CMS Part B by Provider and Service, 2023; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2021.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Atorvastatin Calcium | Atorvastatin Calcium | 86 | 6,385 | $1,033.49 | 40 |
| Lisinopril | Lisinopril | 80 | 5,545 | $797.58 | 29 |
| Simvastatin | Simvastatin | 45 | 4,050 | $483.97 | 20 |
| Levothyroxine Sodium | Levothyroxine Sodium | 45 | 3,295 | $1,056.27 | 21 |
| Amlodipine Besylate | Amlodipine Besylate | 39 | 2,966 | $234.30 | 22 |
| Omeprazole | Omeprazole | 33 | 2,670 | $552.50 | 18 |
| Pantoprazole Sodium | Pantoprazole Sodium | 31 | 2,790 | $503.65 | 18 |
| Sertraline Hcl | Sertraline Hcl | 30 | 2,400 | $273.76 | 13 |
| Fluticasone Propionate | Fluticasone Propionate | 30 | 1,253 | $521.28 | 18 |
| Zolpidem Tartrate | Zolpidem Tartrate | 28 | 840 | $119.39 | โ |
| Metoprolol Succinate | Metoprolol Succinate | 26 | 2,040 | $1,160.64 | 13 |
| Ezetimibe | Ezetimibe | 26 | 1,980 | $1,766.97 | โ |
| Allopurinol | Allopurinol | 24 | 1,680 | $223.12 | 15 |
| Rosuvastatin Calcium | Rosuvastatin Calcium | 24 | 1,980 | $510.02 | 12 |
| Montelukast Sodium | Montelukast Sodium | 23 | 2,070 | $372.64 | 13 |
| Alprazolam | Alprazolam | 22 | 640 | $181.93 | โ |
| Metformin Hcl | Metformin Hcl | 21 | 1,230 | $160.19 | โ |
| Azelastine Hcl | Azelastine Hcl | 21 | 642 | $512.68 | 15 |
| Losartan Potassium | Losartan Potassium | 18 | 1,440 | $323.71 | โ |
| Venlafaxine Hcl Er | Venlafaxine Hcl | 18 | 1,020 | $308.45 | โ |
| Atenolol | Atenolol | 15 | 1,290 | $375.24 | โ |
| Escitalopram Oxalate | Escitalopram Oxalate | 15 | 1,230 | $157.93 | โ |
| Quetiapine Fumarate | Quetiapine Fumarate | 15 | 581 | $431.12 | โ |
| Metformin Hcl Er | Metformin Hcl | 15 | 1,170 | $84.05 | โ |
| Mirtazapine | Mirtazapine | 14 | 578 | $269.95 | โ |
(top 25 shown)
Source: CMS Part D by Provider and Drug, 2021; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 363L00000X
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
NUCC Taxonomy Code: 363LA2200X
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSSources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Internal Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner - Adult Health
Nurse Practitioner, Adult-Gerontology Nurse Practitioner (Certified)
Nurse Practitioner - Family
Family Nurse Practitioner
Internal Medicine
Doctor of Medicine (M.D.)
Internal Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner - Adult Health
Doctor of Nursing Practice, Nurse Practitioner (Certified)
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 267 E MAIN ST BLDG C, SMITHTOWN, NY 117872847 (Tel: 6314188069)
Registered at 45 RESEARCH WAY STE 208A, EAST SETAUKET, NY 117336401 (Tel: 6316752125)
NPI status registered as active in NPPES database
Registered at 1706 AVALON PINES DR, CORAM, NY 117275142 (Tel: 6317076360)
Registered at 1706 AVALON PINES DR, CORAM, NY 117275142 (Tel: 6317076360)
Recorded as NANCY BALKON, PHD, NP, FAANP
Nurse Practitioner (license number reported to NPPES: NY 300564)
NPI status registered as active in NPPES database
Registered at 720 NORTHERN BLVD, LS BLDNG, RM 154, BROOKVILLE, NY 11548 (Tel: 5162992347)
Registered at PO BOX 835, HUNTINGTON, NY 117430835 (Tel: 6317076360)
Recorded as NANCY BALKON, PHD, NP, FAANP
Nurse Practitioner (license number reported to NPPES: NY 300564)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Nurse Practitioners in Smithtown
- Linda Ekert, NP
- Nancy Fortin, ANPC
- Vincent Alestra, AGPCNP, RN
- Bibi Narain, RN, MSN, FNP-BC
- Toniann Savage, NP
- Jennifer Cassidy, FNP
Mailing Address
45 Research Way Ste 208a
East Setauket, NY 117336401
Phone: 6316752125