Individual provider Active NPI

Anupam Banerjee, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1053948299
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA12310600 Issued in NJ
Practice address
750 Albany St Ste 2R
Boston, MA 02118-2520
Phone
(617) 638-6975
Fax
(617) 638-6959
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA12310600 NJ Primary

Addresses

Primary practice location

750 Albany St Ste 2R
Boston, MA 02118-2520

Mailing address

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-2419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814005029 NJ Practitioner - Anesthesiology 3577974468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical Branch at Galveston, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Jersey Healthcare Specialists PCGroup PAC ID 2668385253, 570 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1914
Phone (201) 488-0066

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12310600NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Jul 1, 2024 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1053948299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ALBANY ST STE 2R",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182520",
            "telephone_number": "617-638-6975",
            "fax_number": "617-638-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJEE",
        "first_name": "ANUPAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA12310600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.