Individual provider Active NPI

Mary Ann Banerji, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Brooklyn, NY
National Provider Identifier
1790779957
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
138292-1 Issued in 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
Last updated
Sep 21, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 138292-1 NY Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100630000794 NY Practitioner - Endocrinology 8628109923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Temple University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 826-4959

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
138292-1NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Current Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 26, 2022 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers CurrentSince Jan 26, 2022 Accepting new patients
University Physicians of Brooklyn, Inc. Endocrinology, Diabetes & Metabolism CurrentSince Jan 11, 2016 Accepting new patients
University Physicians of Brooklyn, Inc. CurrentSince Jan 11, 2016 Accepting new patients

Locations

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

450 Clarkson Ave
#123
Brooklyn, NY 11203

450 Clarkson Ave
#1230
Brooklyn, NY 11203
Phone (718) 270-3777

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

450 Clarkson Ave
Ste A
Brooklyn, NY 11203
Phone (718) 270-1432

470 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 421-1003

840 Lefferts Ave
Brooklyn, NY 11203
Phone (718) 493-0300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: maryannbanerji@sunydmc.allscriptsdirect.net
  • Direct secure messaging: mbanerji1050750@nychhc.direct-ci.com

Organizations & group practices 5

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.

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1790779957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 123",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-1542",
            "fax_number": "718-270-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "SUITE A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-1542",
            "fax_number": "718-270-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANERJI",
        "first_name": "MARY ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "138292-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.