Individual provider Active NPI

Kristine Ann Banas, APN

  • Nurse Practitioner
  • Vineland, NJ
National Provider Identifier
1588441802
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ14898800 Issued in NJ
Practice address
1138 E Chestnut Ave Ste 8a
Vineland, NJ 08360-5053
Phone
(856) 691-1230
Fax
(844) 728-1976
NPI assigned
Sep 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 26NJ14898800 NJ Primary

Addresses

Primary practice location

1138 E Chestnut Ave Ste 8a
Vineland, NJ 08360-5053

Mailing address

1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone (856) 575-7369

Other practice location 1

1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone (856) 575-7369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240410000475 NJ Practitioner - Nurse Practitioner 9830537802 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14898800NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Alliance, LLC Family Medicine CurrentSince Feb 5, 2024 Accepting new patients
Dendrinos Medical Associates, P.a. Past Accepting new patients

Locations

1138 E Chestnut Ave
Bldg A
Vineland, NJ 08360
Phone (856) 691-1230

2020 E Chestnut Ave
Vineland, NJ 08361
Phone (856) 563-1600

1138 E Chestnut Ave
Ste 8A
Vineland, NJ 08360
Phone (856) 691-1230

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12810/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1588441802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 DELSEA DR N",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080281444",
            "telephone_number": "856-575-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 E CHESTNUT AVE STE 8A",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605053",
            "telephone_number": "856-691-1230",
            "fax_number": "844-728-1976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 Delsea Dr N",
            "address_purpose": "LOCATION",
            "city": "Glassboro",
            "state": "NJ",
            "postal_code": "080281444",
            "country_code": "US",
            "telephone_number": "856-575-7369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANAS",
        "first_name": "KRISTINE ANN",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ14898800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.