Robert Banco, MD PC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

59668 Issued in MA

Legal business name

ROBERT BANCO, MD PC

Practice address

125 Parker Hill Ave
Converse 4
Roxbury Crossing, MA 02120-2847

Phone

(617) 754-5630

Fax

(617) 754-5593

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Robert J Banco, M.D.

Title

President

Phone

(617) 754-5630

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1700872413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "address_2": "CONVERSE 4",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-5630",
            "fax_number": "617-754-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARKER HILL AVE",
            "address_2": "CONVERSE 4",
            "city": "ROXBURY CROSSING",
            "state": "MA",
            "postal_code": "021202847",
            "telephone_number": "617-754-5630",
            "fax_number": "617-754-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT BANCO, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "BANCO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-754-5630",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MA",
            "license": "59668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "17798",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9724290",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0006139",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "059668",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Rainville, MD
• Frank F Rand, M.D.
• Muralidharan Thiruvenkadam Reddy, MD
• Joan Yvonne Reede, MD
• Janet Wilson Rich-Edwards, PH. D.
• Valerie L Robertson, FNP-BC
• Roxbury Preparatory
• Michael Ruhoy, MD
• Amin F Sabra, MD
• Jennifer P Samatis, OTA

• Orthopaedic Surgery of the Spine Physician in Roxbury Crossing, MA
• Providers in Roxbury Crossing, MA by specialty
• Orthopaedic Surgery of the Spine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.