Amy M Banaszak, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-990213 Issued in CO

Practice address

325 E Fontanero St
Colorado Springs, CO 80907

Phone

(719) 636-3829

Fax

(719) 633-8571

NPI assigned

Sep 23, 2011

Last updated

Nov 7, 2013By the provider in NPPES

Sex

Female

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 1

Other names 1

• Miss Amy M Johnson Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colorado Springs Endocrine Clinic PC

  • Endocrinology, Diabetes & Metabolism Physician
  • Colorado Springs, CO
  • NPI 1336101765
  Medicare reassignment NPD
• Uch-MHS

  dba UCHealth Lifeline

  • Ambulance
  • Colorado Springs, CO
  • NPI 1417512559
  NPD (past)
• Quantum Plus LLC

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1235188962
  NPD (past)

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1215210471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E FONTANERO ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-636-3829",
            "fax_number": "719-633-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E FONTANERO ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-636-3829",
            "fax_number": "719-633-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASZAK",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "NP-990213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16922778",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "JOHNSON",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gina C Bamberger, D.O.
• Myranda Bamford
• Erin Bammann, MD
• Christina Lodell Bammes, M.D.
• Amanda Mae Banas, D.O.
• Dean Bancroft, O.D.
• Gale Banda, M.ED,
• Deanna Bandini Wood, PTA
• Trevor Banes
• James C Banich, MD

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.