Mina Banoub, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME158439 Issued in FL

Practice address

1900 Don Wickham Dr
Clermont, FL 34711-1979

Phone

(352) 536-8840

Fax

(352) 536-8841

NPI assigned

Jun 26, 2018

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

Medicare fee-for-service enrollment

Enrolled in NJ, FL2 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 2

Specialty

Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
• Orlando Health Hospital, Orlando, FL, CCN 100006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment Care Compare group NPD
• Floridian Hospitalist Services, LLC

  • Hospitalist Physician
  • Melbourne, FL
  • NPI 1831530385
  Medicare reassignment NPD
• Lake Wales Physician Services, LLC

  • Hospitalist Physician
  • Lake Wales, FL
  • NPI 1164902797
  Medicare reassignment NPD
• Ridgewood Physician Services, LLC

  • Hospitalist Physician
  • Davenport, FL
  • NPI 1295216034
  Medicare reassignment NPD
• Passaic Hospitalist Services, LLC

  • Hospitalist Physician
  • Paterson, NJ
  • NPI 1144903733
  Medicare reassignment NPD
• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment NPD
• St. Joseph'S Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment NPD
• Floridian Hospitalist Services, LLC

  • Hospitalist Physician
  • Crestview, FL
  • NPI 1881049997
  NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation
• South Lake Hospital, Inc.

  • General Acute Care Hospital
  • Clermont, FL
  • NPI 1336221019
  Care Compare affiliation

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1235624974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8840",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANOUB",
        "first_name": "MINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA11135000",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME158439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bandur Chiropractic Center
• Joseph Bandur
• Joelle June Bangsund, MSW, LCSW
• Trinae Banks-Pinder, M.ED
• Krystin Paige Banks, IMH23880
• Chantal P Baptiste, APRN
• Alrick Barbaza
• Vase Bari, M.D.
• Kevin Carson Barker
• Jennifer Barnes

• Internal Medicine Physician in Clermont, FL
• Providers in Clermont, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.