Individual provider Active NPI

Co V Banh, MD

  • Physical Medicine & Rehabilitation Physician
  • Fremont, CA
National Provider Identifier
1710017074
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A95318 Issued in CA
Practice address
39350 Civic Center Dr Ste 300
Fremont, CA 94538-2331
Phone
(510) 797-3933
Fax
(510) 585-2396
NPI assigned
Mar 6, 2007
Last updated
May 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A95318 CA Primary

Addresses

Primary practice location

39350 Civic Center Dr Ste 300
Fremont, CA 94538-2331

Mailing address

39350 Civic Center Dr Ste 300
Fremont, CA 94538-2331
Phone (510) 797-3933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081203000655 CA Practitioner - Physical Medicine and Rehabilitation 3476614850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Albert Einstein College of Medicine of Yeshiva University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mission Peak Orthopaedic Medical Group IncGroup PAC ID 9739165705, 15 clinicians

Practice addresses (Care Compare)

39350 Civic Ctr Dr
Suite 300
Fremont, CA 94538-2331
Phone (510) 797-3933

Merit-based Incentive Payment System (MIPS)

Final score
96.02 of 100Reported as group
Quality
86.58
Improvement activities
40
Cost
87.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95318CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Peak Orthopaedic Medical Group, Inc Physical Medicine & Rehabilitation CurrentSince Jul 7, 2008 Accepting new patients
Algos Inc., a Medical Corporation Past Accepting new patients
Mission Peak Orthopaedic Medical Group Inc. Physical Medicine & Rehabilitation Past Accepting new patients
Mission Peak Orthopaedic Medical Group, Inc Physical Medicine & Rehabilitation Past Accepting new patients

Locations

39350 Civic Center Dr
Ste 300
Fremont, CA 94538
Phone (510) 797-3933

27206 Calaroga Ave
Ste 107
Hayward, CA 94545
Phone (510) 300-9898

27206 Calaroga Ave
Ste 207
Hayward, CA 94545
Phone (510) 649-1573

5924 Stoneridge Dr
Ste 200
Pleasanton, CA 94588
Phone (925) 846-6200

Interoperability endpoints

  • Direct secure messaging: cbanh138553@hpmg.direct-ci.net

Organizations & group practices 4

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1710017074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR STE 300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "510-797-3933",
            "fax_number": "510-797-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR STE 300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "510-797-3933",
            "fax_number": "510-585-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANH",
        "first_name": "CO",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A95318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.