Mary Banaszak Kirby, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200300632 Issued in NC

Practice address

1040 Medical Park Ave
New Bern, NC 28562-5248

Phone

(252) 633-1678

Fax

(252) 633-1403

NPI assigned

May 26, 2006

Sex

Female

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 2

Other names 1

• Mary Jo Banaszak Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Family Practice

Education

Brody School of Medicine at East Carolina University, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Carolina Health Care PAGroup PAC ID 9739087693, 122 clinicians

Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Pollocksville, NC, CCN 347333
• Centerwell Home Health Home health agency, Morehead City, NC, CCN 347171
• Pruitthealth Home Health New Bern Home health agency, New Bern, NC, CCN 347026
• Carolina East Medical Center Hospital, New Bern, NC, CCN 340131
• Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkirby27150@coastalcarolinahealthcenter.gardenplot.direct-ci.com

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.

• Coastal Carolina Health Care PA

  • Internal Medicine Physician
  • New Bern, NC
  • NPI 1750567970
  Medicare reassignment Care Compare group NPD
• Coastal Carolina Health Care

  • Gastroenterology Physician
  • New Bern, NC
  • NPI 1275572794
  NPD
• Coastal Carolina Health Care PA

  • Family Medicine Physician
  • New Bern, NC
  • NPI 1366498297
  NPD
• Coastal Carolina Health Care PA

  • Family Medicine Physician
  • Morehead City, NC
  • NPI 1821959610
  NPD
• Coastal Carolina Health Care PA

  • Internal Medicine Physician
  • New Bern, NC
  • NPI 1780623207
  NPD (past)

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

• Carolinaeast Medical Center

  • General Acute Care Hospital
  • New Bern, NC
  • NPI 1801852835
  Care Compare affiliation
• Home Health Care of Carteret County, LLC

  • Home Health Agency
  • Morehead City, NC
  • NPI 1528098324
  Care Compare affiliation
• Pitt County Memorial Hospital Inc

  • General Acute Care Hospital
  • Washington, NC
  • NPI 1780359687
  Care Compare affiliation
• Pitt County Memorial Hospital, Inc

  • General Acute Care Hospital
  • Greenville, NC
  • NPI 1043218944
  Care Compare affiliation
• Pruitthealth Home Health, Inc.

  • Home Health Agency
  • New Bern, NC
  • NPI 1891197380
  Care Compare affiliation
• Tar Heel Health Care Services, LLC

  • Home Health Agency
  • Pollocksville, NC
  • NPI 1043243835
  Care Compare affiliation

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1104872316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12248",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612248",
            "telephone_number": "252-633-1678",
            "fax_number": "252-633-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MEDICAL PARK AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625248",
            "telephone_number": "252-633-1678",
            "fax_number": "252-633-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "MARY",
        "middle_name": "BANASZAK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200300632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "134X7",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134X7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BANASZAK",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn P. King, MD
• Natori Amore King
• Rosetta King
• Diane Kinsey
• Alex Kirby, MD
• Victoria Taylor Kirkland, PT
• Taylor Banks Kirkman, D.O.
• Thomas O Kirsch, MPT
• Zachary Joseph Kitchen, M.D.
• Alexandra Kleczek, FNP-C

• Family Medicine Physician in New Bern, NC
• Providers in New Bern, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.