Individual provider Active NPI

Theodore Bania, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1669546297
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
181163 Issued in NY
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(212) 523-6745
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 181163 NY
Emergency Medicine Physician 207P00000X 181163 NY Primary

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

407 Airport Executive Park
Nanuet, NY 10954-5288

Other identifiers 1

IdentifierTypeStateIssuer
01621310MedicaidNY

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL tbania@chpnet.org
CONNECT URL tbania@chpnet.org
CONNECT URL theodore.bania@mssm.edu Direct

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
I20080328000653 NY Practitioner - Emergency Medicine 0042396186 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of Ny Upstate Medical University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 987-3100

Hospital & facility affiliations

  • Mount Sinai West Hospital, New York, NY, CCN 330046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Aug 1, 2014 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Fpa Hospital Based Current Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
St Lukes Roosevelt Hospital Center Emergency Medicine Past Accepting new patients

Locations

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

638 Columbus Ave
New York, NY 10024
Phone (212) 523-8672

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1000 10th Ave
#1
New York, NY 10019

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1669546297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AIRPORT EXECUTIVE PARK",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIA",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "NY",
            "license": "181163",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "181163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01621310",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tbania@chpnet.org",
            "affiliation": "N",
            "address_1": "1000 10th Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100191147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "tbania@chpnet.org",
            "affiliation": "N",
            "address_1": "1000 10th Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100191147",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "theodore.bania@mssm.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 10th Ave # Rmge01",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100191147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.