Individual provider Active NPI

Amitabha Banerjee, M.D.

  • Pediatrics Physician
  • Flint, MI
National Provider Identifier
1386639813
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301037964 Issued in MI
Practice address
1125 S Linden Rd
Suite 500
Flint, MI 48532-4073
Phone
(810) 230-2323
Fax
(810) 732-3199
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301037964 MI Primary

Addresses

Primary practice location

1125 S Linden Rd
Suite 500
Flint, MI 48532-4073

Mailing address

G1125 South Linden Rd
Suite 500
Flint, MI 48532
Phone (810) 230-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160531000620 MI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3274553557

National Provider Directory

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386639813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G1125 SOUTH LINDEN RD",
            "address_2": "SUITE 500",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "810-230-2323",
            "fax_number": "810-732-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 S LINDEN RD",
            "address_2": "SUITE 500",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324073",
            "telephone_number": "810-230-2323",
            "fax_number": "810-732-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJEE",
        "first_name": "AMITABHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301037964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.