NPIMap

Organization Active NPI

Michael J Banome

  • Physical Therapist
  • Bayside, NY
National Provider Identifier
1093313504
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MICHAEL J BANOME
Practice address
2812 201St St
Bayside, NY 11360-2321
Phone
(347) 804-4956
NPI assigned
Oct 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Authorized official

Name
Michael Joseph Banome, PT, DPTNPI 1659737393
Title
Physical Therapist
Phone
(347) 804-4956

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2812 201St St
Bayside, NY 11360-2321

Mailing address

2812 201St St
Bayside, NY 11360-2321
Phone (347) 804-4956

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1093313504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 201ST ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602321",
            "telephone_number": "347-804-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 201ST ST",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602321",
            "telephone_number": "347-804-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J BANOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "BANOME",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "347-804-4956",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.