NPIMap

Organization Active NPI

Keystone Orthopaedic Specialists LLC

  • Orthopaedic Surgery Physician
  • Wyomissing, PA
National Provider Identifier
1255666012
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
KEYSTONE ORTHOPAEDIC SPECIALISTS LLC
Practice address
2607 Keiser Blvd Ste 200
Wyomissing, PA 19610-3326
Phone
(484) 509-0840
Fax
(610) 568-1036
NPI assigned
Oct 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Stephen P Banco, MDNPI 1881686772
Title
President
Phone
(484) 509-0840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2607 Keiser Blvd Ste 200
Wyomissing, PA 19610-3326

Mailing address

2607 Keiser Blvd Ste 200
Wyomissing, PA 19610-3326
Phone (484) 509-0840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100317000260 PA Part B Supplier - Clinic/Group Practice 2062547920 Receives reassigned benefits from 66 practitioners
1 other NPI on this enrollment
Practice locations: Reading, PA; West Reading, PA; Wyomissing, PA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

11 Fairlane Rd
Reading, PA 19606
Phone (610) 378-8810

2758 Century Blvd
Wyomissing, PA 19610
Phone (610) 376-5467

2607 Keiser Blvd
Ste 200
Wyomissing, PA 19610
Phone (484) 509-0840

1235 Penn Ave
Wyomissing, PA 19610
Phone (610) 374-2927

1280 Broadcasting Rd
Wyomissing, PA 19610
Phone (215) 949-3100

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1255666012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 KEISER BLVD STE 200",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103326",
            "telephone_number": "484-509-0840",
            "fax_number": "610-568-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 KEISER BLVD STE 200",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103326",
            "telephone_number": "484-509-0840",
            "fax_number": "610-568-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE ORTHOPAEDIC SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "BANCO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-509-0840",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.