Individual provider Active NPI

Sanjoy Banerjee, M.D.

  • Anesthesiology Physician
  • Corona, CA
National Provider Identifier
1295773422
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A90939 Issued in CA
Practice address
2097 Compton Ave
Suite 102
Corona, CA 92881-7282
Phone
(951) 735-7246
Fax
(951) 268-9516
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A90939 CA Primary

Addresses

Primary practice location

2097 Compton Ave
Suite 102
Corona, CA 92881-7282

Mailing address

2097 Compton Ave
Suite 102
Corona, CA 92881-7282
Phone (951) 735-7246

Other identifiers 1

IdentifierTypeStateIssuer
00A909390MedicaidCA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20051107001055 CA Practitioner - Pain ManagementPractitioner - Addiction MedicinePractitioner - Anesthesiology 8224056395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
90939CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanjoy Banerjee MD Inc Anesthesiology CurrentSince Apr 30, 2003 Accepting new patients
Rochester Imperial Surgical Center LLC PastSince Jun 25, 2014 Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

2097 Compton Ave
Ste 102
Corona, CA 92881
Phone (951) 273-0555

25495 Medical Center Dr
Ste 101
Murrieta, CA 92562
Phone (951) 200-7777

1211 W 6th St
Ontario, CA 91762
Phone (909) 933-6580

36243 Inland Valley Dr
Ste 10
Wildomar, CA 92595
Phone (951) 735-7246

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1295773422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2097 COMPTON AVE",
            "address_2": "SUITE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817282",
            "telephone_number": "951-735-7246",
            "fax_number": "951-268-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2097 COMPTON AVE",
            "address_2": "SUITE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928817282",
            "telephone_number": "951-735-7246",
            "fax_number": "951-268-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJEE",
        "first_name": "SANJOY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A90939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A909390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.