Fidel David Banuelos, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

29000 Center Ridge Rd Ste 150
Westlake, OH 44145-5219

Phone

(440) 827-5566

NPI assigned

Apr 19, 2022

Sex

Male

Sole proprietor

No

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 OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: fbanuelos38786@ehrdirect.uhhospitals.org

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1215670906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29000 CENTER RIDGE RD STE 150",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29000 CENTER RIDGE RD STE 150",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455219",
            "telephone_number": "440-827-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "FIDEL",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ballrick Orthodontics, Inc.
• James Walter Ballrick II, D.D.S.
• John Walter Ballrick, D.D.S., M.S.D.
• Peter Bambakidis, MD
• Saurabh Bansal, MD
• Konstantin Baraz, PT, DPT
• Samir Barazi, MD
• Erica Barb, CNP
• Arianna Maelynn Barnhart
• Sarah M Barone, LPC

• Student in an Organized Health Care Education/Training Program in Westlake, OH
• Providers in Westlake, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.