DR. SAMUEL JACKSON BALIN (M.D., PH.D.) – Dermatology Physician, NPI 1518254481

DR. SAMUEL JACKSON BALIN (M.D., PH.D.) is a healthcare provider. based in Springfield, Oregon. specializing in DERMATOLOGY, PATHOLOGY. They hold the professional credentials M.D., PH.D.. They hold a License No. MD197986 (OR). The NPI Number for DR. SAMUEL JACKSON BALIN (M.D., PH.D.) is 1518254481

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. SAMUEL JACKSON BALIN (M.D., PH.D.)
NPI
1518254481
Phone
(541) 344-4168
Address
860 BELTLINE RD
Enumeration Date
29 June 2011
Last Update Date
7 December 2024

Doctor Profile

Medical School Name
MAYO MEDICAL SCHOOL
Secondary Phone
5413444168
Graduation Year
2011 (15 years ago)
PAC ID
3870863319
Group Practice PAC ID
5698218071
Professional Enrollment ID
I20200721001294
Address ID
OR974771091SP860XXRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:14State licenses:1Digital endpointsOther names

232 DERMATOLOGY in OR

Provider Addresses for DR. SAMUEL JACKSON BALIN (M.D., PH.D.)

  • 860 BELTLINE RD

    SPRINGFIELD, OR 974771091

    Phone: (541) 344-4168

    Fax: (458) 201-8510

    Type: Mailing

  • 5767 W CENTURY BLVD STE 400

    LOS ANGELES, CA 900455631

    Phone:

    Type: Mailing

  • 200 MEDICAL PLZ STE 450

    LOS ANGELES, CA 90095

    Phone: (310) 825-6911

    Fax: (310) 794-7005

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 74 Open Payments records for all available years, with a total value of $1,670.

Total Amount is formed as General ($1,670) + Research ($0) + Ownership ($0) = $1,670.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($323).

Total Amount

$1,670

General + Research + Ownership

Payments

74

Total payment records

General Amount

$1,670

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-07-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200721001294IDermatologyORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths1,005173$0
99213Established patient office or other outpatient visit, 20-29 minutes333290$0
11102Biopsy of related skin growth, first growth254241$0
17000Destruction of precancer skin growth, 1 growth246221$0
11103Biopsy of related skin growth, each additional growth10781$0
View full utilization report →

Insurance plans in this area (ZIP 97477)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5698218071View full group profile
NameSpecialtyState
Micrographic Dermatologic Surgery (Mds), DermatologyOR
Physician AssistantOR
Physician AssistantOR

Reviews

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Frequently asked questions

Does DR. SAMUEL JACKSON BALIN (M.D., PH.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. SAMUEL JACKSON BALIN (M.D., PH.D.) uses 1518254481.
Is DR. SAMUEL JACKSON BALIN (M.D., PH.D.) listed as active for patients and plans?
The listing shows DR. SAMUEL JACKSON BALIN (M.D., PH.D.) as active in the NPI system.
What taxonomy line describes DR. SAMUEL JACKSON BALIN (M.D., PH.D.)?
For research purposes, treat DR. SAMUEL JACKSON BALIN (M.D., PH.D.) as Dermatology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. SAMUEL JACKSON BALIN (M.D., PH.D.) based?
DR. SAMUEL JACKSON BALIN (M.D., PH.D.) is tied to Springfield, Oregon in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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