Individual provider Active NPI

Kareem Bannis, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Mesa, AZ
National Provider Identifier
1134569494
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
52640 Issued in AZ
Practice address
1705 W Main St
Mesa, AZ 85201-6920
Phone
(480) 964-2273
Fax
(480) 718-9477
NPI assigned
Jul 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 52640 AZ Primary
Internal Medicine Physician 207R00000X 52640 AZ

Addresses

Primary practice location

1705 W Main St
Mesa, AZ 85201-6920

Mailing address

3033 N Central Ave Ste 145
Phoenix, AZ 85012-2808
Phone (623) 583-3001

Other identifiers 1

IdentifierTypeStateIssuer
243598MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20170711002962 AZ Practitioner - Internal Medicine 3375835010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adelante Healthcare, IncGroup PAC ID 4688588643, 132 clinicians

Practice addresses (Care Compare)

500 W Thomas Rd
Suite 870
Phoenix, AZ 85013-4218
Phone (877) 809-5092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52640AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adelante Healthcare, Inc CurrentSince Jul 15, 2017 Accepting new patients
Adelante Healthcare, Inc CurrentSince Jul 15, 2017 Accepting new patients
Adelante Healthcare, Inc. Family Medicine Current Accepting new patients
Adelante Healthcare, Inc. Family Medicine Past Accepting new patients

Locations

306 E Monroe Ave
Buckeye, AZ 85326
Phone (623) 386-4814

13471 W Cornerstone Blvd
Goodyear, AZ 85395

1705 W Main St
Mesa, AZ 85201
Phone (480) 845-6769

15525 N 83rd Ave
Ste 104
Peoria, AZ 85382

9520 W Palm Ln
Ste 200
Phoenix, AZ 85037
Phone (623) 556-8860

7725 N 43rd Ave
Ste 510
Phoenix, AZ 85051
Phone (623) 207-5465

3033 N Central Ave
Ste 145
Phoenix, AZ 85012

500 W Thomas Rd
Ste 870
Phoenix, AZ 85013
Phone (602) 263-0222

15317 W Bell Rd
Ste 100
Surprise, AZ 85374

15351 W Bell Rd
Surprise, AZ 85374

811 N Tegner St
Ste 113
Wickenburg, AZ 85390

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1134569494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122808",
            "telephone_number": "623-583-3001",
            "fax_number": "623-974-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 W MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852016920",
            "telephone_number": "480-964-2273",
            "fax_number": "480-718-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNIS",
        "first_name": "KAREEM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "52640",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "52640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243598",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.