NPIMap

Individual provider Active NPI

Trevor Raymond Banka, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Detroit, MI
National Provider Identifier
1508069618
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
4301089873 Issued in MI
Practice address
2799 W Grand Blvd
CFP-6
Detroit, MI 48202-2608
Phone
(313) 916-3898
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 4301089873 MI Primary
Orthopaedic Surgery Physician 207X00000X 264801 NY

Addresses

Primary practice location

2799 W Grand Blvd
CFP-6
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
CFP-6
Detroit, MI 48202-2608
Phone (313) 916-3898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131010000825 MI Practitioner - Orthopedic Surgery 1355575150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Michigan State University College of Human Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

Hospital & facility affiliations

  • Henry Ford Home Health Care Home health agency, Detroit, MI, CCN 237087
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146
  • Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement115
Knee replacement193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
264801NYMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Orthopaedic Surgery CurrentSince May 17, 2018 Accepting new patients
Henry Ford Health System Past Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1961 S Telegraph Rd
Bloomfield Township, MI 48302
Phone (248) 319-6190

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

2799 W Grand Blvd
#6
Detroit, MI 48202
Phone (313) 916-3879

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 1F
Detroit, MI 48202
Phone (313) 874-4907

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: tbanka207736@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1508069618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "CFP-6",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "CFP-6",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKA",
        "first_name": "TREVOR",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MI",
            "license": "4301089873",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "264801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.