Mark S. Banasiak, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC23625 Issued in CA

Practice address

27555 Ynez Rd Ste 350
Temecula, CA 92591-4688

Phone

(951) 587-2225

Fax

(951) 365-0027

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wine Country Chiropractic Mark S. Banasiak DC Inc. a Professional Corp

  • Chiropractor
  • Temecula, CA
  • NPI 1316259377
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1033299359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27555 YNEZ RD STE 350",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914688",
            "telephone_number": "951-587-2225",
            "fax_number": "951-676-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27555 YNEZ RD STE 350",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914688",
            "telephone_number": "951-587-2225",
            "fax_number": "951-365-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASIAK",
        "first_name": "MARK",
        "middle_name": "S.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "DC0236251",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ63647Y",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Temecula, CA
• Providers in Temecula, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.