Sharon Sanford Banasiewicz, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 9106960 Issued in FL

Practice address

2452 Mahan Dr Ste 101
Tallahassee, FL 32308-5377

Phone

(850) 877-2126

Fax

(850) 877-6046

NPI assigned

Dec 6, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1245575935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2452 MAHAN DR STE 101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085377",
            "telephone_number": "850-877-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2452 MAHAN DR STE 101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085377",
            "telephone_number": "850-877-2126",
            "fax_number": "850-877-6046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASIEWICZ",
        "first_name": "SHARON",
        "middle_name": "SANFORD",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA 9106960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roman Alexander Balsys, DO
• Efren L Baltazar, MD
• Tia Balthrop, RCSWI
• Stephen Dale Bamford, LCSW
• Florence P Bamgbose, ARNP
• Kacey Anne Banaszek, LMHC
• Jennifer Vanessa Bandin, RN
• Kelly A Bane, PA-C, MPH
• Tracy L Bane, LCSW
• Jenna Banks-Roman, PSY.D.

• Surgical Physician Assistant in Tallahassee, FL
• Providers in Tallahassee, 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 Oct 26, 2016; 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.