Gregory M. Banicki, M.S. ED.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1910 Saint Joe Center Rd
Fort Wayne, IN 46825-5000

Phone

(260) 484-5599

Fax

(260) 484-5664

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Indiana Medical College, School of Medicine of Purdue University, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Phoenix Associates Inc.

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1407917966

  IN

  Medicare reassignment NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184785693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255000",
            "telephone_number": "260-484-5599",
            "fax_number": "260-484-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255000",
            "telephone_number": "260-484-5599",
            "fax_number": "260-484-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANICKI",
        "first_name": "GREGORY",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "M.S. ED.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie R Bandy, DPT, ATC
• Tabitha J Bane
• Ashley Baney
• Jill A. Baney, NP
• Michael James Bangert, MICHAEL BANGERT, OD
• Maegan Banicki
• Jakyria Monae-Tyree Banks
• Regan J Banks, MS ED
• Amanjit Kaur Banwait
• Philip Bao, MD

• All providers in Fort Wayne, IN
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.