NPIMap

Organization Active NPI

Imelda Cruz-Banting, MD, PC

  • Clinic/Center
  • New Rochelle, NY
National Provider Identifier
1467642140
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
212537 Issued in NY
Legal business name
IMELDA CRUZ-BANTING, MD, PC
Practice address
108 Van Guilder Ave
New Rochelle, NY 10801-5406
Phone
(914) 712-3144
Fax
(718) 944-6266
NPI assigned
Jul 27, 2007
Last updated
Jul 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Dr. Imelda Mangahas Cruz-BantingNPI 1760458137
Title
Owner
Phone
(914) 779-3710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 212537 NY Primary
Medical Specialty Clinic/Center 261QM2500X 212537 NY

Addresses

Primary practice location

108 Van Guilder Ave
New Rochelle, NY 10801-5406

Mailing address

12 Apple CT
Eastchester, NY 10709-5540
Phone (914) 779-3710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090505000461 NY Part B Supplier - Clinic/Group Practice 1658260179 Receives reassigned benefits from 1 practitioner
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

108 Van Guilder Ave
New Rochelle, NY 10801
Phone (914) 633-1516

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1467642140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 APPLE CT",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107095540",
            "telephone_number": "914-779-3710",
            "fax_number": "718-944-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 VAN GUILDER AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015406",
            "telephone_number": "914-712-3144",
            "fax_number": "718-944-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMELDA CRUZ-BANTING, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "CRUZ-BANTING",
        "authorized_official_first_name": "IMELDA",
        "authorized_official_middle_name": "MANGAHAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-779-3710",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "212537",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "212537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.