Babu S Bangaru, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

128235 Issued in NY

Practice address

11175 Campus Street
Coleman Pavilion Suite # A1120
Loma Linda, CA 92354-9235

Phone

(909) 558-4773

Fax

(909) 558-0479

NPI assigned

Sep 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: bbangaru330798@direct.llu.edu
• Direct secure messaging: bbangaru6697@direct.medisys.org

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.

• Children'S Hospital Los Angeles Medical Group, Inc.

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1265530653
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Neurological Surgery Physician
  • Murrieta, CA
  • NPI 1912004920
  NPD
• Children'S Hospital Los Angeles

  • Children's Chronic Disease Hospital
  • Los Angeles, CA
  • NPI 1366527954
  NPD (past)

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1457546582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9422 59TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735151",
            "telephone_number": "718-592-7797",
            "fax_number": "718-685-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 CAMPUS STREET",
            "address_2": "COLEMAN PAVILION SUITE # A1120",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923549235",
            "telephone_number": "909-558-4773",
            "fax_number": "909-558-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANGARU",
        "first_name": "BABU",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "128235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dann Omar Gans Banaag, DNP, NNP-C
• Kristen Rae Bandy, M.D.
• Anamika Isha Banerji, MD
• Eunji Bang
• Sunny Bang, MD
• Dawn O Banks, P.A.
• Firas Bannout, M.D
• Sabrina Yeak-Hoah Banos, MD
• Daljeet B Bansal, MD
• Ramesh Bansal, M.D.

• Pediatric Gastroenterology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pediatric Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.