Diane Renee Banigo, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

R152803-1 Issued in MN

Practice address

3033 Excelsior Blvd Ste 585
Minneapolis, MN 55416-6400

Phone

(612) 345-5920

Fax

(844) 562-6828

NPI assigned

Mar 24, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

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 6

Other names 1

• Diane Isaac Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: diane.banigo.1@14062.direct.athenahealth.com

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.

• North Memorial Health Care

  dba North Memorial Health - Minnetonka Medical Center

  • Primary Care Clinic/Center
  • Minnetonka, MN
  • NPI 1952732729
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639139470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 585",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554166400",
            "telephone_number": "612-345-5920",
            "fax_number": "844-562-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 EXCELSIOR BLVD STE 585",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554166400",
            "telephone_number": "612-345-5920",
            "fax_number": "844-562-6828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Cesar Chavez St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551072226",
            "country_code": "US",
            "telephone_number": "651-793-2272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3310 Live Oak St",
            "address_2": "Ste: 210",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752046153",
            "country_code": "US",
            "telephone_number": "214-821-5400",
            "fax_number": "214-821-5415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANIGO",
        "first_name": "DIANE",
        "middle_name": "RENEE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "152803-1",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R152803-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "088H5BA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238495700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "182098",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP58089",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "07-04617",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "923911045942",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "ISAAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodi L Bangert, PA
• Stephen Bangh
• Elizabeth Ann Bangle, RN
• Yaria Isabella Bangura
• Nicole Rae Banick, PA-C
• Donald Rost Banik, D.O., MPH
• Ratan K Banik, MD, PHD
• Adam L. Bank, PHD
• Sandipan Pati Bankim Behari Pati
• Marilyn Bankole

• Advanced Practice Midwife in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Advanced Practice Midwife in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.