Elias Ignacio Banuelos, MD
Individual provider Active NPI Family Medicine Physician · Calistoga, CA
NPI 1366427064 · NPPES record last updated Sep 29, 2022
Key facts
- NPI
- 1366427064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A72691 (CA)
- Practice address
- 911 Washington St
Calistoga, CA 94515-1433 - Phone
- (707) 709-2308
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Stanford University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Adventist Health Physicians Network
Practice addresses (Care Compare)
1524 W Lacey Blvd
Suite 101
Hanford, CA 93230-5990
Phone (559) 583-4695
821 S Saint Helena Hwy
Suite 2
Saint Helena, CA 94574-2266
Phone (707) 968-9232
913 Washington St
Calistoga, CA 94515-1433
Hospital & facility affiliations
- Providence at Home With Compassus Home Health, Napa Valley
- Silverline Staff Home Health
- Sutter Care at Home
- Accentcare Home Health of California, Inc
- Adventist Health St Helena
- Adventist Health Clearlake
- Providence Queen of the Valley Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220906001518 | CA | Practitioner - Family Practice | 1052414992 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A72691 | CA | MD | Family Medicine Physician |
| ME97139 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health Physicians Network | Current |
Accepting new patients | |
| Ole Health | Current |
Accepting new patients | |
| Adventist Health Physicians Network | Current |
Accepting new patients | |
| Ole Health | Current | Accepting new patients | |
| Ole Health | Current |
Accepting new patients | |
| Adventist Health Physicians Network | Current | Accepting new patients | |
| Sacred Heart Health System, Inc. | Past | Accepting new patients | |
| Vipcare Dental PLLC | Past |
Accepting new patients | |
| Adventist Health Heart Institute-Ukiah | Past | Accepting new patients | |
| Santa Rosa Hma Urgent Care LLC | Past | Accepting new patients | |
| Tri Hospital MRI Center | Past | Accepting new patients |
Locations
911 Washington St
Calistoga, CA 94515
Phone (707) 709-2308
913 Washington St
Calistoga, CA 94515
Phone (707) 942-0844
1141 Pear Tree Ln
Ste 100
Napa, CA 94558
Phone (707) 254-1778
1222 Pine St
Ste A
Saint Helena, CA 94574
Phone (707) 963-0931
10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 963-2002
821 Saint Helena Hwy S
Saint Helena, CA 94574
Phone (707) 963-5006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME97139 | FL | |
| Family Medicine Physician | 207Q00000X | A72691 | CA | Yes |
Addresses
Primary practice location
911 Washington St
Calistoga, CA 94515-1433
Mailing address
1141 Pear Tree LN Ste 100
Napa, CA 94558-6485
Phone (707) 254-1770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A726910 | Medicaid | CA |
Other providers in Calistoga, CA
- Adventist Health Physicians Network
- Adventist Health Physicians Network
- Andrew G Alexander
- Dulce Estrella Alvarado I
- Hector Ayala
- Gabriela Bermudez
- Deborah Ann Black
- Calli Rose Brandyfoot
- Barbara Jean Brown
- Calistoga Junior Senior High School
All providers in Calistoga, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.