Individual provider Active NPI

Vineet Bansal

  • Family Medicine Physician
  • Potsdam, NY
National Provider Identifier
1104068667
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
267481 Issued in NY
Practice address
49 Lawrence Ave
Potsdam, NY 13676-1889
Phone
(315) 261-5550
Fax
(315) 261-5597
NPI assigned
Mar 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 267481 NY Primary

Addresses

Primary practice location

49 Lawrence Ave
Potsdam, NY 13676-1889

Mailing address

50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130103000240 NY Practitioner - Family Practice 5698928406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

49 Lawrence Ave
Potsdam, NY 13676-1889
Phone (315) 261-5550

Hospital & facility affiliations

  • Health Services of Northern New York Inc Chha Home health agency, Potsdam, NY, CCN 337256
  • Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197
  • SLHS Massena, Inc Hospital, Massena, NY, CCN 331322
  • The University of Vermont Health Network-Alice Hy Hospital, Malone, NY, CCN 331321

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267481NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Canton-Potsdam Hospital CurrentSince Nov 7, 2012 Accepting new patients
Canton-Potsdam Hospital CurrentSince Nov 7, 2012 Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

49 Lawrence Ave
Potsdam, NY 13676
Phone (315) 261-5550

Interoperability endpoints

  • Direct secure messaging: vbansal324968@direct.rochesterregional.org

Organizations & group practices 3

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 4

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": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1104068667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300",
            "fax_number": "315-261-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 LAWRENCE AVE",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761889",
            "telephone_number": "315-261-5550",
            "fax_number": "315-261-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "VINEET",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-30",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "267481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

Verify at the official NPI Registry.