Amy P Bansal, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

A167507 Issued in CA

Practice address

2080 Century Park E Ste 710
Los Angeles, CA 90067-2010

Phone

(310) 715-3237

NPI assigned

Apr 28, 2014

Last updated

Mar 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 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

Specialty

Otolaryngology

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT Group of Los AngelesGroup PAC ID 4880902790, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Cedars Sinai Tarzana Medical Center Hospital, Tarzana, CA, CCN 050761

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Emerald Gardens Hospice, Inc.

  dba Butterfly Hospice

  • Community Based Hospice Care Agency
  • Upland, CA
  • NPI 1982142170

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Hospice of Orange County, Inc.

  • Community Based Hospice Care Agency
  • Fullerton, CA
  • NPI 1417381336

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer

  CMS ownership

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.

• ENT Group of Los Angeles

  • Otolaryngology Physician
  • Tarzana, CA
  • NPI 1518359850
  Medicare reassignment Care Compare group NPD
• Innovative Medical Solutions Inc a Medical Group

  • Adolescent Medicine (Internal Medicine) Physician
  • Panorama City, CA
  • NPI 1972624955
  Medicare reassignment NPD
• Jagan N. Bansal, M.D., Inc.

  dba Complete Family Medical Clinic

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1043392962
  Medicare reassignment NPD
• Hospice of Orange County, Inc.

  • Community Based Hospice Care Agency
  • Fullerton, CA
  • NPI 1417381336
  NPD (past) Authorized official
• Jagan N. Bansal, M.D., Inc.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1013099936
  NPD
• Tarzana Medical Center LLC

  dba Providence Cedars-Sinai Tarzana Medical Center

  • General Acute Care Hospital
  • Tarzana, CA
  • NPI 1821250762
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tarzana Medical Center LLC

  dba Providence Cedars-Sinai Tarzana Medical Center

  • General Acute Care Hospital
  • Tarzana, CA
  • NPI 1821250762
  Care Compare affiliation

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1437569613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917881475",
            "telephone_number": "909-973-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK E STE 710",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900672010",
            "telephone_number": "310-715-3237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5540 N Figueroa St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900424120",
            "country_code": "US",
            "telephone_number": "909-973-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "AMY",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2022-03-02",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "MD-47306",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A167507",
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CA",
            "license": "A167507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abansal@imsmedgroup.cm",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2080 Century Park E Ste 710",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900672010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serguei Ivanovich Bannykh, MD
• Azita Banooni, D.C.
• Marjan Banooni, M.D.
• Matthew Banooni
• Sarah Bansak
• Eric J Bansal, M.D.
• Jagan Bansal, M.D.
• Maneesh A Bansal, M.D.
• Manvi Bansal, M.D.
• Sumati Bansal, D.O.

• Otolaryngology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.