Sanjay Bansal, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G66178 Issued in CA

Practice address

3540 Mendocino Avenue
Suite 200
Santa Rosa, CA 95403-3639

Phone

(707) 522-6200

Fax

(707) 522-6215

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Jay Bansal Professional name

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

Specialty

Ophthalmology

Education

University of Nebraska College of Medicine, 1988

Medicare assignment

May accept Medicare assignment

Group practices

Laservue Eye Center Medical CorporationGroup PAC ID 4284717794, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

23.99 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

79.97

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Laservue Eye Center Medical Corporation

  • Ophthalmologic Surgery Clinic/Center
  • Santa Rosa, CA
  • NPI 1194913103
  Medicare reassignment Care Compare group NPD Authorized official
• Laservue Eye Center a Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Santa Rosa, CA
  • NPI 1811372568
  NPD (past)
• North Sonoma County Health Care District

  • Medicare Defined Swing Bed Hospital Unit
  • Healdsburg, CA
  • NPI 1043308539
  NPD (past)
• Pacific Vision Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • San Francisco, CA
  • NPI 1841858594

  Ophthalmology

  NPD (past)
• SRM Alliance Hospital Services

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1346275484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 MENDOCINO AVENUE",
            "address_2": "SUITE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033639",
            "telephone_number": "707-522-6200",
            "fax_number": "707-522-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 MENDOCINO AVENUE",
            "address_2": "SUITE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033639",
            "telephone_number": "707-522-6200",
            "fax_number": "707-522-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G66178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "BANSAL",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bana Solomon, LLC
• Barbara Fraser Banchero, LCSW
• Amy Marie Bandiera
• Fatemeh Ahdi Bani-Taba, PSYD
• Andrea Bankson
• Kelsey Hana Banz
• Colin Alexander Baptie, PSY.D.
• Leora Bar-Din, AMFT, APCC
• Gisselle Barajas Tinajero
• Cheyenne Barajas, ASW

• Ophthalmology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.