Mary Ann Banerji, M.D.
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Brooklyn, NY
NPI 1790779957 · NPPES record last updated Sep 21, 2007
Key facts
- NPI
- 1790779957
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 138292-1 (NY)
- Practice address
- 450 Clarkson Ave
Suite a
Brooklyn, NY 11203-2056 - Phone
- (718) 270-1542
- Fax
- (718) 270-1534
- NPI assigned
- Sep 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Endocrinology
- Education
- Temple University School of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Physicians of Brooklyn, Inc.
Practice addresses (Care Compare)
450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 826-4959
Hospital & facility affiliations
- Suny/Downstate University Hospital of Brooklyn
- Kings County Hospital Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100630000794 | NY | Practitioner - Endocrinology | 8628109923 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138292-1 | NY | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles (5 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physicians of Brooklyn, Inc. | Current |
Accepting new patients | |
| University Hospital of Brooklyn Suny Downstate Health Sciences Univers | Current |
Accepting new patients | |
| University Physicians of Brooklyn, Inc. | Current | Accepting new patients | |
| University Hospital of Brooklyn Suny Downstate Health Sciences Univers | Current |
Accepting new patients | |
| University Physicians of Brooklyn, Inc. | Endocrinology, Diabetes & Metabolism | Current |
Accepting new patients |
Locations
450 Clarkson Ave
Ste A
Brooklyn, NY 11203
Phone (718) 270-1432
450 Clarkson Ave
#123
Brooklyn, NY 11203
450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481
450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603
470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003
840 Lefferts Ave
Brooklyn, NY 11203
Phone (718) 493-0300
450 Clarkson Ave
#1230
Brooklyn, NY 11203
Phone (718) 270-3777
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- maryannbanerji@sunydmc.allscriptsdirect.net
- mbanerji1050750@nychhc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 138292-1 | NY | Yes |
Addresses
Primary practice location
450 Clarkson Ave
Suite a
Brooklyn, NY 11203-2056
Mailing address
450 Clarkson Ave
Box 123
Brooklyn, NY 11203-2056
Phone (718) 270-1542
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02267650 | Medicaid | NY |
Other providers in Brooklyn, NY
- Moshe Aharon Bandman
- Albertha Bando
- Zoran J Bandovic
- Bandstand Corporation
- Brinda Banerji
- Abena Banful
- Haneul Bang
- Shreshtha Banga
- Putta Shankar Bangalore Annaiah
- Onrush Bangar
All providers in Brooklyn, NY · Endocrinology, Diabetes & Metabolism Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.