Leo A Banwart, PA-C

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0010881 Issued in IA

Practice address

1221 S Gear Ave
West Burlington, IA 52655

Phone

(319) 768-3628

Fax

(319) 768-3633

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

77.06 of 100Reported as group

Quality

64.36

Promoting interoperability

81

Improvement activities

40

Cost

75.01

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southeast Iowa Regional Medical Center, Inc.

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884

  Emergency Medical Technician, Basic

  NPD
• Southeast Iowa Regional Medical Center, Inc.

  • Community Based Hospice Care Agency
  • West Burlington, IA
  • NPI 1053315002
  NPD (past)

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1598747891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 668",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "526550668",
            "telephone_number": "319-768-3628",
            "fax_number": "319-768-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S GEAR AVE",
            "city": "WEST BURLINGTON",
            "state": "IA",
            "postal_code": "52655",
            "telephone_number": "319-768-3628",
            "fax_number": "319-768-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANWART",
        "first_name": "LEO",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "IA",
            "license": "001088",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "0010881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BX",
            "identifier": "49776",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MC",
            "identifier": "930097503",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Anderson
• Gerald Arnold, MD
• Luke Arnold
• David Bainbridge, PHARMD
• Michael J Baird, M.S.
• Masharib Bashar, M.D.
• Alisha Lorene Bassler, DDS
• Wyatt Dale Baxter, PA-C
• Mary Catherine Bentler, P.A.
• Jennifer K Berge, M.D.

• Emergency Medicine Physician in West Burlington, IA
• Providers in West Burlington, IA by specialty
• Emergency Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.