Individual provider Active NPI

Jericho Barcomb Banker, NP

  • Family Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1518220441
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337319 Issued in NY
Practice address
322 Lake Ave
Rochester, NY 14608-1162
Phone
(585) 254-6480
NPI assigned
Jun 15, 2012
Last updated
Jun 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 337319 NY Primary

Addresses

Primary practice location

322 Lake Ave
Rochester, NY 14608-1162

Mailing address

1741 Bragg St
Lima, NY 14485-9724
Phone (585) 721-4211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140730000016 NY Practitioner - Nurse Practitioner 6002032976 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
337319NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Jan 1, 2018 Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2018 Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2018 Accepting new patients
Pophealthcare Medical Services of Az, PC Family PastSince Aug 4, 2024 Accepting new patients
Pophealthcare Medical Services of Az, PC PastSince Aug 4, 2024 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1425 Portland Ave
Bldg 1
Rochester, NY 14621
Phone (585) 338-1400

Interoperability endpoints

  • Direct secure messaging: jericho.banker.1@29290.direct.athenahealth.com
  • Direct secure messaging: jericho.banker.2@29290.direct.athenahealth.com
  • Direct secure messaging: jericho.banker@jh.eclinicaldirectplus.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1518220441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 BRAGG ST",
            "city": "LIMA",
            "state": "NY",
            "postal_code": "144859724",
            "telephone_number": "585-721-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081162",
            "telephone_number": "585-254-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKER",
        "first_name": "JERICHO",
        "middle_name": "BARCOMB",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.