Krisandra Banet

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10003208A Issued in IN

Practice address

1111 W Kenyon Rd Ste B
Urbana, IL 61801-1006

Phone

(217) 729-7657

NPI assigned

Apr 7, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • New Albany, IN
  • NPI 1477297083
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1043849391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 CHARLESTOWN RD STE 100",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471501998",
            "telephone_number": "812-944-7500",
            "fax_number": "812-944-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W KENYON RD STE B",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618011006",
            "telephone_number": "217-729-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANET",
        "first_name": "KRISANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003208A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan S Bailey, DMD, MD
• Tamaca Bailey, LPN
• Ronald Baker, CRNA
• Julia K Balikian, PA
• Hannah M Balow
• Thomas Bangert
• Kelsey Banks, LSW
• Katelyn Bannon, CNP
• Samih Barcham
• Lynne Nicole Barcus, M.S., CCC-SLP

• Physician Assistant in Urbana, IL
• Providers in Urbana, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.
• 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.