Deba Banerji, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

192748 Issued in NY

Practice address

4771 Hylan Blvd
Staten Island, NY 10312-6315

Phone

(718) 948-8200

Fax

(718) 948-8433

NPI assigned

Mar 29, 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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 4880945955, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Icahn School of Medicine at Mount Sinai

  • Hematology & Oncology Physician
  • Staten Island, NY
  • NPI 1457867707
  Medicare reassignment Care Compare group
• Mount Sinai School of Medicine of New York University

  • Internal Medicine Physician
  • Scarsdale, NY
  • NPI 1023334927
  Medicare reassignment NPD
• Mount Sinai School of Medicine of New York University

  • Orthopaedic Surgery Physician
  • Yonkers, NY
  • NPI 1336878651
  NPD

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1073574240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2791 RICHMOND AVE",
            "address_2": "2ND FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145859",
            "telephone_number": "718-816-6440",
            "fax_number": "718-948-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126315",
            "telephone_number": "718-948-8200",
            "fax_number": "718-948-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJI",
        "first_name": "DEBA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "192748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01724285",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Massandjenie Bamba
• Sarah Kachollom Bamiro
• Yetunde Bamisayo Bamisile, LMSW
• Anthony C Banas, DC
• Steven Richard Banat, MD
• Jacqueline Bangayan-Tan, RN
• Kadiaja Bangurai, LPN
• Sahra Banja
• Adewunmi Julius Bankole, NURSE PRACTITIONER
• Bolaji Bankole, M.D.

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.
• 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.