Individual provider Active NPI

George Thomas Banyas, O.D.

  • Optometrist
  • Gibsonia, PA
National Provider Identifier
1336249044
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0EG000754 Issued in PA
Practice address
300 Walmart Dr
Gibsonia, PA 15044-9610
Phone
(724) 449-3341
Fax
(724) 449-2798
NPI assigned
Sep 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0EG000754 PA Primary

Addresses

Primary practice location

300 Walmart Dr
Gibsonia, PA 15044-9610

Mailing address

332 Steeplechase Dr
Cranberry TWP, PA 16066-2244
Phone (724) 538-5776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091202000090 PA Practitioner - Optometry 7911046149 Practice locations: Gibsonia, PA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0EG000754PAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336249044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 STEEPLECHASE DR",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160662244",
            "telephone_number": "724-538-5776",
            "fax_number": "724-538-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WALMART DR",
            "city": "GIBSONIA",
            "state": "PA",
            "postal_code": "150449610",
            "telephone_number": "724-449-3341",
            "fax_number": "724-449-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANYAS",
        "first_name": "GEORGE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "0EG000754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibsonia, PA

Sources for this page

Verify at the official NPI Registry.