Jose L. Banuelos Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G47968 Issued in CA

Practice address

1448 Florida Ave
Modesto, CA 95350-4424

Phone

(209) 523-1884

Fax

(209) 522-6002

NPI assigned

Sep 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.505006

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.

• Orangeburg Medical Group

  • Surgery Physician
  • Modesto, CA
  • NPI 1467595389

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1427158351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504424",
            "telephone_number": "209-523-1884",
            "fax_number": "209-522-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504424",
            "telephone_number": "209-523-1884",
            "fax_number": "209-522-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "JOSE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G47968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0021000",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth F Banks, PHARMD
• Jade Ima'N Banks
• Laila Ali Banks
• Elizabeth Grace Sashi Bans
• Faith Benita Banson
• Luisana Ramos Baptista, CMT
• Miranda Baptista
• Traci Ann Baptista, RN
• Juan Barahona, DO
• Jocelyn Barajas Iniguez

• Family Medicine Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.