Premilla Banwait, OD

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

2805 Issued in CO

Practice address

13123 E 16TH Ave
Aurora, CO 80045-7106

Phone

(720) 777-1234

NPI assigned

Apr 2, 2010

Last updated

Aug 16, 2012By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: pbanwait57222@direct-ucsfmedicalcenter.org

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

{
    "created_epoch": "1270166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1043535008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANWAIT",
        "first_name": "PREMILLA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-02",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CO",
            "license": "2805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61458261",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Bannister
• Anip Bansal, M.D.
• Varun Vivek Bansal, MBBS
• Tahseena Banu, DDS
• Tiana Banuelos
• Elizabeth B.a. Banwart, DO
• Michael Banwart, PSYD
• Stacey Lee Bar-Chaim, LCSW
• Courtney Baraglia, APN
• Abakar Baraka

• Pediatric Optometrist in Aurora, CO
• Providers in Aurora, CO by specialty
• Pediatric Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.