Sean Patrick Alonza Bannister, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9105846 Issued in FL

Practice address

745 NW Federal Hwy
Stuart, FL 34994-1016

Phone

(772) 247-7545

Fax

(772) 264-3272

NPI assigned

Feb 7, 2007

Last updated

Sep 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts, Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kairwell Weight and Wellness LLC

  • Multi-Specialty Clinic/Center
  • Stuart, FL
  • NPI 1629688221
  NPD Authorized official
• Coastal Care Corporation

  dba Cleveland Clinic Imaging

  • Radiology Clinic/Center
  • Port St Lucie, FL
  • NPI 1558320556
  NPD (past)
• Martin Memorial Medical Center Inc

  dba Cleveland Clinic Martin North, South, Tradition Hospitals

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055
  NPD (past)
• Stuart Cardiovascular Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Stuart, FL
  • NPI 1366487878
  NPD (past)
• Stuart Cardiovascular Associates, PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Stuart, FL
  • NPI 1003851502
  NPD (past)
• Inphynet Primary Care Physicians Southeast PC

  • Emergency Medicine Physician
  • Columbus, GA
  • NPI 1770521460
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1205976487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349941016",
            "telephone_number": "772-247-7545",
            "fax_number": "772-264-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349941016",
            "telephone_number": "772-247-7545",
            "fax_number": "772-264-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNISTER",
        "first_name": "SEAN",
        "middle_name": "PATRICK ALONZA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105846",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9105846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003293800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y06TH",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Jo Ballingham
• Zoe Balzano
• Brandon Banks
• Kendia Kenydia Banks
• Hannah G Banning
• Banyan Detox, LLC (Banyan Stuart)
• Roseline Baptiste
• Cecilia Barajas, FNP
• Brittany Barbee
• April Barber

• Surgical Physician Assistant in Stuart, FL
• Providers in Stuart, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.