Eric W. Bantz, M.D.

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

MA48238 Issued in NJ

Practice address

103 Old Marlton Pike Ste 211
Medford, NJ 08055-8772

Phone

(609) 953-7500

Fax

(609) 953-9085

NPI assigned

Jan 23, 2007

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 11

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: ewbantz@advancedent.emadirect.md

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.

• ENT and Allergy Associates LLP

  • Otolaryngology Physician
  • Tarrytown, NY
  • NPI 1376598326
  NPD

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1124172598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE STE 211",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558772",
            "telephone_number": "609-953-7500",
            "fax_number": "609-953-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 OLD MARLTON PIKE STE 211",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558772",
            "telephone_number": "609-953-7500",
            "fax_number": "609-953-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTZ",
        "first_name": "ERIC",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NJ",
            "license": "MA48238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER #",
            "identifier": "0811426",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID",
            "identifier": "P381888",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE INSURANCE ID",
            "identifier": "147995",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5312302",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010003124010",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "3373326",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "721570737",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83386",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PRIME PROVIDER ID",
            "identifier": "J017341",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HMO PROVIDER",
            "identifier": "0350808000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON-MERCY",
            "identifier": "60012703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bancroft, a New Jersey Nonprofit Corporation
• Bancroft, a New Jersey Nonprofit Corporation
• Bancroft, a New Jersey Nonprofit Corporation
• Bancroft, a New Jersey Nonprofit Corporation
• Lisa A. Banks, PHARMD
• Todd M. Barge, MPT
• Lacretia Renee Barnes, LPN,LMT
• John Barnett
• Jeanne Marie Bauer, M.A., L.P.C.
• Nicole Diane Baylies, LPC LCADC

• Allergy Physician in Medford, NJ
• Providers in Medford, NJ by specialty
• Allergy Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.