Chaim Banjo MD PHD PA

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G4442 Issued in TX

Legal business name

CHAIM BANJO MD PHD PA

Practice address

718 W Moore Ave
101
Terrell, TX 75160

Phone

(972) 551-1900

NPI assigned

Sep 27, 2006

Organization subpart

No

Name

Dr. Chaim Banjo, MD PHDNPI 1588730121

Title

Owner

Phone

(972) 686-7947

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chaim Banjo, MD PHD

  • Cardiovascular Disease Physician
  • Terrell, TX
  • NPI 1588730121

  TX

  Medicare reassignment Authorized official

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 8, 2011.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1366533952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 W MOORE AVE",
            "address_2": "101",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "75160",
            "telephone_number": "972-551-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 W MOORE AVE",
            "address_2": "101",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "75160",
            "telephone_number": "972-551-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAIM BANJO MD PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "BANJO",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-686-7947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD  PHD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "G4442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109453402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING PROVIDER",
            "identifier": "85A011",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Care to You Enterprises LLC
• Fernando Carmona, LMSW-ACP
• Ashley Carter, LPC
• Mary E Carver, MSN
• Rakesh Chadalavada, M.D.
• Elyse M Chance, LVN
• Chidoziri Chibundu
• Stephen Chilton
• Shahzad Aslam Choudhry
• Casheba Christopher, LPC

• All providers in Terrell, TX
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.