Bannett Eye Centers, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25MB04846500 Issued in NJ

Legal business name

BANNETT EYE CENTERS, PA

Practice address

620 N Broad St
Woodbury, NJ 08096-1795

Phone

(856) 853-5554

Fax

(856) 853-5650

NPI assigned

Jan 10, 2007

Last updated

Sep 20, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregg Allen Bannett, DONPI 1720097157

Title

Owner

Phone

(856) 853-5554

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Bannett Eye Centers PA

  • Eyewear Supplier
  • Woodbury, NJ
  • NPI 1821007261

  7517913916

  Same PAC ID

Tax ID family

Bannett Eye Centers PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bannett Eye Centers PA

  • Eyewear Supplier
  • Woodbury, NJ
  • NPI 1821007261
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Bannett Eye Centers PA

  • Eyewear Supplier
  • Woodbury, NJ
  • NPI 1821007261
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregg Allen Bannett, DO

  • Ophthalmology Physician
  • Woodbury, NJ
  • NPI 1720097157
  Medicare reassignment Care Compare group NPD Authorized official
• Harrison Phillip Bannett, DO

  • Ophthalmology Physician
  • Woodbury, NJ
  • NPI 1851898381
  Medicare reassignment Care Compare group NPD
• Kara Della Torre, M.D.

  • Ophthalmology Physician
  • Woodbury, NJ
  • NPI 1649491978
  Medicare reassignment Care Compare group NPD
• Jeffrey S. Forman, M.D.

  • Ophthalmology Physician
  • Voorhees, NJ
  • NPI 1427056050
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1437208287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961795",
            "telephone_number": "856-853-5554",
            "fax_number": "856-853-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961795",
            "telephone_number": "856-853-5554",
            "fax_number": "856-853-5650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 Haddonfield Berlin Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434378",
            "country_code": "US",
            "telephone_number": "856-853-5554",
            "fax_number": "856-853-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BANNETT EYE CENTERS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "BANNETT",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-853-5554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MB04846500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgen-Ashlee Backus, CNS, LDN
• Emily Bacon, APN-C
• Jennie Baile, LCSW
• Samantha Baney, MA, LAC
• Bannett Eye Centers PA
• Gregg Allen Bannett, DO
• Harrison Phillip Bannett, DO
• Julia Bardales, LMFT, MT-BC
• Jessica Barner
• Jordan Biet Barnett, MD FACEP FAAEM FACHE

• Ophthalmology Physician in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.