Clement S. K. Banda, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D046607 Issued in MD

Practice address

7120 Minstrel Way
Suite 103
Columbia, MD 21045-5248

Phone

(443) 283-0600

Fax

(443) 283-0399

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

DermatologyAlso: Internal Medicine

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FCJCCA/Endpoint/FCJCCA

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.

• MD Laser Medicine and Surgery Inc

  • Dermatology Physician
  • Columbia, MD
  • NPI 1750693503

  Phlebology

  Medicare reassignment NPD Authorized official
• MD Laser Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Columbia, MD
  • NPI 1346581105
  Medicare reassignment NPD Authorized official
• Dresnick Sterling Emergency Physicians of Maryland PA

  • Emergency Medicine Physician
  • Bel Air, MD
  • NPI 1083664908
  NPD (past)
• Dresnick Sterling Emergency Physicians of Maryland PA

  • Emergency Medicine Physician
  • Havre de Grace, MD
  • NPI 1609826536
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Hospital Physician Services, LLLP

  • General Acute Care Hospital
  • Westminster, MD
  • NPI 1457302713
  NPD (past)
• Joseph S. Fastow, M.D., P.a.

  • Critical Access Hospital
  • Prince Frederick, MD
  • NPI 1861443103
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550275200000",
    "number": "1255385498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455248",
            "telephone_number": "443-283-0600",
            "fax_number": "443-283-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455248",
            "telephone_number": "443-283-0600",
            "fax_number": "443-283-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDA",
        "first_name": "CLEMENT",
        "middle_name": "S. K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "MD",
            "license": "D0046607",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MD",
            "license": "D0046607",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "D0046607",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D046607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Rendon Baltazar, M.D.
• Baltimore Washington Surgery Center, L.L.C.
• Balum Imaging LLC
• Aisha Bamidele
• Philomera Bamugye Jones
• Tafadzwa Banda
• Nitika Bansal Bandara, MD
• Kamiya Monet Bandy
• Fatima Bangura, MD
• Osman Bangura

• Dermatology Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2019; 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.