Ellen Mary Bando, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2333 Issued in AZ

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649

Phone

(928) 729-8000

Fax

(928) 729-3355

NPI assigned

Oct 26, 2005

Last updated

May 19, 2025By 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 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VT, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Fort Defiance Indian Hospital Board, IncorporationGroup PAC ID 0941336697, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fort Defiance Indian Hospital Hospital, Ft. Defiance, AZ, CCN 030071

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21546/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment Care Compare group
• Gifford Health Care, Inc

  • General Practice Physician
  • Randolph, VT
  • NPI 1013269430
  Medicare reassignment NPD
• Gifford Medical Center Inc.

  • General Acute Care Hospital
  • Randolph, VT
  • NPI 1942329446
  Medicare reassignment NPD
• Springfield Medical Care Systems Inc.

  • Federally Qualified Health Center (FQHC)
  • Springfield, VT
  • NPI 1730336843
  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • Ambulatory Surgical Clinic/Center
  • Fort Defiance, AZ
  • NPI 1487977914
  NPD
• Gifford Health Care, Inc

  dba Gifford Pedicatric and Adolescent Medicine

  • Federally Qualified Health Center (FQHC)
  • Randolph, VT
  • NPI 1831782929
  NPD
• Springfield Medical Care Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Springfield, VT
  • NPI 1457979130
  NPD

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1699765057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000",
            "fax_number": "928-729-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000",
            "fax_number": "928-729-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDO",
        "first_name": "ELLEN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2025-05-19",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0569",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0030836",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000244",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "518160",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30334002",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherno Bah, PMH-NP
• Edlin David Bain, PHARM. D.
• Anna Baldwin, RN, BSN, IBCLC
• Juddson Baldwin, PA-C
• Chuck L Ball, MD
• Alfredo Ayo Bantug Jr., RRT
• David J Barnes, MD
• Linda R Barnes, CNM
• Jennifer L Barnett, R.N.
• Kathryn Barron, ANP

• Physician Assistant in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.

Verify at the official NPI Registry.