Individual provider Active NPI

Sabina Banu

  • Internal Medicine Physician
  • Utica, NY
National Provider Identifier
1598504342
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P128223 Issued in NY
Practice address
1657 Sunset Ave
Utica, NY 13502-5415
Phone
(315) 797-7392
NPI assigned
May 22, 2024
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P128223 NY Primary

Addresses

Primary practice location

1657 Sunset Ave
Utica, NY 13502-5415

Mailing address

1657 Sunset Ave
Utica, NY 13502-5415
Phone (315) 797-7392

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801003270 NY Practitioner - Internal Medicine 3375080880 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P128223NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mill Basin Medical Health PC Internal Medicine CurrentSince May 27, 2024 Accepting new patients
Grand Mohawk Valley LLC Past Accepting new patients

Locations

257 State St
Batavia, NY 14020
Phone (585) 343-1300

1583 E 66th St
#1
Brooklyn, NY 11234
Phone (917) 318-4724

48 Frost Ln
Unit A
Lawrence, NY 11559
Phone (516) 587-9960

1657 Sunset Ave
Utica, NY 13502
Phone (315) 797-7392

14310 20th Ave
Whitestone, NY 11357
Phone (718) 961-1212

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1598504342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025415",
            "telephone_number": "315-797-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025415",
            "telephone_number": "315-797-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANU",
        "first_name": "SABINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P128223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.