Individual provider Active NPI

Kaitlyn Jane Banks, P.A.

  • Physician Assistant
  • New York, NY
National Provider Identifier
1265981641
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4618 Issued in CT
Practice address
333 E 38TH St
New York, NY 10016-2772
Phone
(646) 501-7223
NPI assigned
Sep 27, 2016
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 655094 TX
Physician Assistant 363A00000X 4618 CT Primary

Addresses

Primary practice location

333 E 38TH St
New York, NY 10016-2772

Mailing address

104 N Bryan St
Borger, TX 79007-4010
Phone (806) 274-3627

Other practice location 1

104 N Bryan St
Borger, TX 79007-4010
Phone (806) 274-3627

Other practice location 2

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbanks498557@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170504000500 TX Practitioner - Physician Assistant 8628355427
I20220728001115 NY Practitioner - Physician Assistant 8628355427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

111 Broadway
FL 2
New York, NY 10006-1995
Phone (212) 263-9701

333 E 38TH St
New York, NY 10016-2772
Phone (646) 356-9400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
655094TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
High Plains Family Medicine PA CurrentSince Mar 19, 2017 Accepting new patients
New York University CurrentSince Jul 25, 2022 Accepting new patients
New York University CurrentSince Jul 25, 2022 Accepting new patients

Locations

333 E 38th St
New York, NY 10016
Phone (646) 501-7070

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

104 N Bryan St
Borger, TX 79007
Phone (806) 274-2986

Interoperability endpoints

  • Direct secure messaging: kbanks498557@nyumc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1265981641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N BRYAN ST",
            "city": "BORGER",
            "state": "TX",
            "postal_code": "790074010",
            "telephone_number": "806-274-3627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 38TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162772",
            "telephone_number": "646-501-7223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 N Bryan St",
            "address_purpose": "LOCATION",
            "city": "Borger",
            "state": "TX",
            "postal_code": "790074010",
            "country_code": "US",
            "telephone_number": "806-274-3627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 Washington St",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063602740",
            "country_code": "US",
            "telephone_number": "860-889-8331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKS",
        "first_name": "KAITLYN",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "655094",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbanks498557@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "333 E 38th St",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100162772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.