Individual provider Active NPI

Lisa Ingrid Banchik, M.D.

  • Neurology Physician
  • Boca Raton, FL
National Provider Identifier
1699705863
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME0055218 Issued in FL
Practice address
5458 Town Center Rd
Suite #22
Boca Raton, FL 33486-1089
Phone
(561) 392-2950
Fax
(561) 391-2970
NPI assigned
Jul 4, 2006
Last updated
Jun 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME0055218 FL Primary

Addresses

Primary practice location

5458 Town Center Rd
Suite #22
Boca Raton, FL 33486-1089

Mailing address

5458 Town Center Rd
Suite #22
Boca Raton, FL 33486-1089
Phone (561) 392-2950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070404000072 FL Practitioner - Neurology 6103920970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Miami, LM Miller School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ezr ResearchGroup PAC ID 0547787434, 10 clinicians

Practice addresses (Care Compare)

2900 N Military TRL
Suite 110
Boca Raton, FL 33431-6347
Phone (561) 788-7545

5458 Town Ctr Rd
Suite 1
Boca Raton, FL 33486-1089
Phone (561) 342-2950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0055218FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Centers of Palm Beach Inc Neurology CurrentSince May 5, 2006 Accepting new patients
Ezr Research CurrentSince Dec 1, 2025 Accepting new patients

Locations

2900 N Military Trl
Ste 110
Boca Raton, FL 33431
Phone (561) 362-0510

5458 Town Center Rd
Ste 1
Boca Raton, FL 33486
Phone (561) 376-8935

5458 Town Center Rd
Ste 22
Boca Raton, FL 33486
Phone (561) 235-5497

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1699705863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5458 TOWN CENTER RD",
            "address_2": "SUITE #22",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861089",
            "telephone_number": "561-392-2950",
            "fax_number": "561-391-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5458 TOWN CENTER RD",
            "address_2": "SUITE #22",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861089",
            "telephone_number": "561-392-2950",
            "fax_number": "561-391-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANCHIK",
        "first_name": "LISA",
        "middle_name": "INGRID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0055218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.