Robin J Bansal

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

8267 Issued in CT

Practice address

131 New London Tpke Ste 105
Glastonbury, CT 06033-2246

Phone

(860) 430-5599

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Nurse Practitioner

Education

University of Connecticut School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avanta Clinic LLCGroup PAC ID 9931456894, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robin.bansal.1@17722.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/17722/brand/1/csg/1/fhir/r4

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.

• Avanta Clinic LLC

  • Internal Medicine Physician
  • Glastonbury, CT
  • NPI 1619467826
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1659932333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 NEW LONDON TPKE STE 105",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332246",
            "telephone_number": "860-430-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 NEW LONDON TPKE STE 105",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332246",
            "telephone_number": "860-430-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "ROBIN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "8267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Mark Balloch, DDS
• Lucinda Maria Balsome, M.S.,R.D.
• Devon Nicholas Banda, DO
• Arjun Banerjee, MD
• Ali Banki, D.O.
• Sudeep Bansal, M.D.
• Christopher Michael Barclay, BCBA, NCSP
• Neal David Barkoff, M.D.
• Jillian June Barnes, FNP
• Jessica K Barr, LMT

• Nurse Practitioner in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.