Individual provider Active NPI

Sheena Banerjee, MD

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1407834385
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29745 Issued in AZ
Practice address
2510 W Dunlap Ave
Suite 290
Phoenix, AZ 85021-2737
Phone
(602) 789-0344
Fax
(602) 789-8279
NPI assigned
Jan 2, 2006
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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 29745 AZ Primary

Addresses

Primary practice location

2510 W Dunlap Ave
Suite 290
Phoenix, AZ 85021-2737

Mailing address

2510 W Dunlap Ave
Suite 290
Phoenix, AZ 85021-2737
Phone (602) 789-0344

Other identifiers 1

IdentifierTypeStateIssuer
624313MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29745AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allkids Urgent Care, LLC Past Accepting new patients

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": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1407834385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 W DUNLAP AVE",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212737",
            "telephone_number": "602-789-0344",
            "fax_number": "602-789-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJEE",
        "first_name": "SHEENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "29745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "624313",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.