JAMES BALARBAR, MD
Emergency Medical Services (Emergency Medicine) Physician in ROUND ROCK, Texas. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: JAMES BALARBAR, MD filed 210 Medicare Part D claims in 2023 across ROUND ROCK, Texas. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
JAMES BALARBAR, MD practices in an ABMS-board-eligible specialty but we don't have enough CMS-participation signals to confirm active board-certified status. Consult CertificationMatters.org (the official ABMS public lookup).
JAMES BALARBAR, MD at a glance
Quality data not reportedPrimary specialty
Medicare Part D claims
Specialty distribution in Texas
How Emergency Medical Services (Emergency Medicine) Physician compares to other specialties among Texas providers
Emergency Medical Services (Emergency Medicine) Physician share within Texas
Emergency Medical Services (Emergency Medicine) Physician is one of the more visible NUCC categories in Texas
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Specialty board-certification context
Estimated specialty board-certified rate — Emergency Medical Services (Emergency Medicine) Physician (ABMS / AOA reference)
- Est. board-certified rate
- 78%
- Emergency Medical Services (Emergency Medicine) Physician ABMS/AOA estimate
Est. board-certified rate (Emergency Medical Services (Emergency Medicine) Physician) — ABMS / AOA estimate
Verify credentials
- Verify via ABMS free public lookup
- Verify via AOA osteopathic boards
- Specialty volume Emergency Medical Services (Emergency Medicine) Physician US NPIs
Specialty board-certified rate — Emergency Medical Services (Emergency Medicine) Physician estimate
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus Maintenance of Certification cycles. CMS does not publish a per-provider board-certification field; the figure shown is the specialty-level estimated rate from ABMS / AOA reference data.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
JAMES BALARBAR, MD is a Emergency Medical Services (Emergency Medicine) Physician provider practicing in ROUND ROCK, Texas, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1194783787. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.
JAMES BALARBAR, MD appears in the CMS NPPES registry as a Emergency Medical Services (Emergency Medicine) Physician provider holding MD credentials at 2400 ROUND ROCK AVE, ROUND ROCK, TX, 78681, with a listed phone of (512) 341-1000. NPI 1194783787 was issued on 05/03/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what BALARBAR most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 210 prescription claims written by this provider, covering 146 Medicare beneficiaries and totaling roughly $2K in drug spend, with an opioid prescribing rate of 17.6%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy.
Emergency Medical Services (Emergency Medicine) Physician is a narrow specialty nationwide, with 3,616 enrolled providers across 55 states and an average of 394 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1194783787 |
|---|---|
| Specialty | Emergency Medical Services (Emergency Medicine) Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 05/03/2006 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm JAMES BALARBAR, MD's current license status, disciplinary history, and board certifications with the Texas Medical Board in Texas before relying on this page for a clinical or care decision.
How we sourced this profile
License & disciplinary context — Texas TMB 2023 annual report
Aggregate state board data only — NOT a determination of any individual provider's status. The figures below describe statewide disciplinary activity across all ~77K Texas medical licensees in 2023 — they are NOT specific to JAMES BALARBAR, MD. To verify JAMES BALARBAR, MD's current license status, search the TMB public license lookup directly, or check the Federation of State Medical Boards (FSMB) verification service.
TMB publishes annual disciplinary statistics as part of public-record reporting under each state's Administrative Procedure Act. See the full breakdown by action type and year on the Texas disciplinary trends page. Cross-checked against FSMB U.S. Medical Regulatory Trends.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 211
- Total Day Supply
- 1,728
- Generic Drug Cost
- $1K
- Opioid Claims
- 37 (17.6% rate)
- Antibiotic Claims
- 65
Patient Demographics
- Average Patient Age
- 68.0 years
- Avg HCC Risk Score
- 1.43
- Gender Split
- 68% female / 32% male
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 32 |
| Cephalexin | 21 |
| Ondansetron Odt Ondansetron | 18 |
| Prednisone | 18 |
| Doxycycline Hyclate | 15 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Emergency Medical Services (Emergency Medicine) Physician Overview
How JAMES BALARBAR, MD fits within the Emergency Medical Services (Emergency Medicine) Physician landscape nationally.
JAMES BALARBAR, MD's 210 claims are below the specialty average of 394.
Nearby Emergency Medical Services (Emergency Medicine) Physician Providers in Texas
Other clinicians with the same primary specialty enrolled in Texas, drawn from the same CMS NPPES roster as BALARBAR.
Healthcare Guides
Learn more about finding, verifying, and understanding healthcare providers.
Explore Texas
Frequently Asked Questions
What is JAMES BALARBAR, MD's specialty? ▼
How much does JAMES BALARBAR, MD prescribe under Medicare Part D? ▼
Where is JAMES BALARBAR, MD located? ▼
What is JAMES BALARBAR, MD's NPI number? ▼
Does JAMES BALARBAR, MD prescribe opioids? ▼
How many Emergency Medical Services (Emergency Medicine) Physician providers are there in the US? ▼
What drugs does JAMES BALARBAR, MD prescribe most often? ▼
Does JAMES BALARBAR, MD accept Medicare? ▼
How can I verify JAMES BALARBAR, MD's credentials? ▼
Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology