Individual provider Active NPI

Nicole Loraine Banks, PA-C

  • Surgical Physician Assistant
  • Mesa, AZ
National Provider Identifier
1548742307
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
2945 S Dobson Rd
Mesa, AZ 85202-7941
Phone
(480) 969-4138
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X AZ
Surgical Physician Assistant 363AS0400X AZ Primary

Addresses

Primary practice location

2945 S Dobson Rd
Mesa, AZ 85202-7941

Mailing address

6140 E Fairfield St
Mesa, AZ 85205-5963
Phone (480) 232-9039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190112000217 AZ Practitioner - Physician Assistant 2769728781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians

Practice addresses (Care Compare)

10510 N 92ND St
Scottsdale, AZ 85258-4566

3501 N Scottsdale Rd
Scottsdale, AZ 85251-5650

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (480) 882-6700

7400 E Thompson Peak Pkwy
Scottsdale, AZ 85255-4109
Phone (480) 324-7000

9003 E Shea Blvd
Scottsdale, AZ 85260-6709
Phone (480) 323-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Healthcare Corporation CurrentSince Nov 3, 2022 Accepting new patients
Honorhealth Ambulatory CurrentSince Nov 3, 2022 Accepting new patients

Locations

19636 N 27th Ave
Ste 408
Phoenix, AZ 85027
Phone (623) 780-0100

33300 N 32nd Ave
Ste 205
Phoenix, AZ 85085
Phone (602) 962-0071

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

3501 N Scottsdale Rd
Ste 320
Scottsdale, AZ 85251
Phone (480) 424-7228

Interoperability endpoints

  • Direct secure messaging: nbanks498894@direct.honorhealth.com

Organizations & group practices 4

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 2

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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1548742307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 E FAIRFIELD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852055963",
            "telephone_number": "480-232-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852027941",
            "telephone_number": "480-969-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "NICOLE",
        "middle_name": "LORAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.