Active NPI
Sean Bannan
- Physician Assistant
- Newark, NJ
National Provider Identifier
1659267300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 201 Lyons Ave
Newark, NJ 07112-2027 - Phone
- (973) 926-7000
- NPI assigned
- Jun 17, 2025
- Last updated
- Jun 17, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
201 Lyons Ave
Newark, NJ 07112-2027
Mailing address
17 Gunther Loop
Somerset, NJ 08873-7354
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 W Gilbert St
Tinton Falls, NJ 07701-4948
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1659267300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 GUNTHER LOOP",
"city": "SOMERSET",
"state": "NJ",
"postal_code": "088737354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071122027",
"telephone_number": "973-926-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNAN",
"first_name": "SEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-06-17",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.