Individual provider Active NPI

Sondra Marie Bantis, ARNP

  • Adult Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1780193177
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
10225 Issued in MN
Practice address
225 Smith Ave N Ste 500
Saint Paul, MN 55102-2545
Phone
(651) 292-0007
Fax
(651) 241-2740
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X ARNP9209588 FL
Adult Health Nurse Practitioner 363LA2200X 10225 MN Primary
Nurse Practitioner 363L00000X ARNP9209588 FL
Gerontology Nurse Practitioner 363LG0600X H155677 IA

Addresses

Primary practice location

225 Smith Ave N Ste 500
Saint Paul, MN 55102-2545

Mailing address

PO Box 43
Minneapolis, MN 55440-0043
Phone (612) 262-1166

Other practice location 1

6500 W Newberry Rd
Gainesville, FL 32605-4392
Phone (844) 673-6968

Other names 1

  • Sondra Marie Bantis Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MN, GA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180522000110 FL Practitioner - Nurse Practitioner 8224394036 Reassigns benefits to 5 organizations
I20230608002158 MN Practitioner - Nurse Practitioner 8224394036
I20250210003324 GA Practitioner - Nurse Practitioner 8224394036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 719
Sunnyside, WA 98944

Hospital & facility affiliations

  • Sunnyside Home Health Home health agency, Sunnyside, WA, CCN 507126
  • Astria Sunnyside Hospital Hospital, Sunnyside, WA, CCN 501330

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10225MNMDSpeech-Language Pathologist
ARNP9209588FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services - Lehigh Physician Management LLC CurrentSince Jul 11, 2018 Accepting new patients
MCR Health, Inc. CurrentSince Jul 6, 2021 Accepting new patients
MCR Health, Inc. CurrentSince Jul 6, 2021 Accepting new patients
Wound Care Physicians of Tampa Bay LLC CurrentSince Mar 1, 2025 Accepting new patients
Saberi Advanced Wound Care LLC CurrentSince Mar 1, 2025 Accepting new patients
Sunnyside Community Hospital Association CurrentSince May 1, 2025 Accepting new patients
Sunnyside Community Hospital Association Current Accepting new patients
Sunnyside Community Hospital Association CurrentSince May 1, 2025 Accepting new patients
Heal Precisely of Northside LLC CurrentSince Mar 1, 2025 Accepting new patients
Heal Precisely of Tampa Bay LLC CurrentSince Mar 1, 2025 Accepting new patients
Sunnyside Community Hospital Association Adult Health CurrentSince May 1, 2025 Accepting new patients
Piedmont Specialty Hospital Billing LLC CurrentSince Dec 5, 2024 Accepting new patients
Transitions Care Management PA PastSince Apr 11, 2016 Accepting new patients

Locations

1530 Lee Blvd
Ste 1100
Lehigh Acres, FL 33936
Phone (239) 303-2600

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

5880 49th St N
Ste N203
St Petersburg, FL 33709
Phone (727) 300-0405

5880 49th St N
Ste N201
St Petersburg, FL 33709
Phone (727) 300-0405

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

2925 Allen Rd
Sunnyside, WA 98944
Phone (509) 837-4949

Organizations & group practices 13

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.

View all 13

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1780193177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400043",
            "telephone_number": "612-262-1166",
            "fax_number": "612-262-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 SMITH AVE N STE 500",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022545",
            "telephone_number": "651-292-0007",
            "fax_number": "651-241-2740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 W Newberry Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326054392",
            "country_code": "US",
            "telephone_number": "844-673-6968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANTIS",
        "first_name": "SONDRA",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9209588",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "10225",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9209588",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IA",
            "license": "H155677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONDRA",
            "last_name": "BANTIS",
            "middle_name": "MARIE",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.