Individual provider Active NPI

Petar R Banovic

  • Pharmacist
  • Larchmont, NY
National Provider Identifier
1285501460
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
073087 Issued in NY
Practice address
2141 Palmer Ave
Larchmont, NY 10538-2406
Phone
(914) 341-1900
NPI assigned
Oct 21, 2025
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 073087 NY Primary

Addresses

Primary practice location

2141 Palmer Ave
Larchmont, NY 10538-2406

Mailing address

1447 159TH St
Whitestone, NY 11357-2720
Phone (914) 708-9618

Other practice location 1

1142 Lexington Ave
New York, NY 10075-0307
Phone (212) 744-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
073087NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Larchmont Pharmacy LLC CurrentSince Dec 7, 2025 Accepting new patients
Matland Pharmacy Corp Past Accepting new patients

Locations

2141 Palmer Ave
Larchmont, NY 10538
Phone (914) 341-1900

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1285501460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 159TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572720",
            "telephone_number": "914-708-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 PALMER AVE",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105382406",
            "telephone_number": "914-341-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1142 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100750307",
            "country_code": "US",
            "telephone_number": "212-744-4144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANOVIC",
        "first_name": "PETAR",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "073087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larchmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.