Individual provider Active NPI

John William Banks III, DO, MS

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1154881746
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
321750 Issued in NY
Practice address
109 W 27TH St Ste 5S
New York, NY 10001-6208
Phone
(254) 366-2534
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 321750 NY Primary

Addresses

Primary practice location

109 W 27TH St Ste 5S
New York, NY 10001-6208

Mailing address

PO Box 235
Lorena, TX 76655-0235
Phone (254) 366-2534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230504002491 NY Practitioner - Psychiatry 6002145273 Reassigns benefits to 1 organization
I20230511000490 FL Practitioner - Psychiatry 6002145273 Reassigns benefits to 1 organization
I20230907003580 TN Practitioner - Psychiatry 6002145273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PA 751 clinicians
MCCD Psychiatry Services PLLC 206 clinicians

Practice addresses (Care Compare)

101 N Monroe St
Suite 800 Private Office 860
Tallahassee, FL 32301-1570
Phone (833) 351-8255

109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255

315 Deaderick St
Suite 1550
Nashville, TN 37238-3003
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Science

State licenses

LicenseStateTypeSpecialty
5372TNMDDentist
321750NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince May 31, 2023 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince May 31, 2023 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

101 N Monroe St
Ste 800
Tallahassee, FL 32301
Phone (321) 300-2108

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

109 W 27th St
New York, NY 10001
Phone (332) 206-6054

315 Deaderick St
Ste 1550
Nashville, TN 37238
Phone (615) 554-3233

Organizations & group practices 2

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1154881746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235",
            "city": "LORENA",
            "state": "TX",
            "postal_code": "766550235",
            "telephone_number": "254-366-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "254-366-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "321750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.