Individual provider Active NPI

Joseph Banno, M.D.

  • Urology Physician
  • Peoria, IL
National Provider Identifier
1811951072
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036053979 Issued in IL
Practice address
7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone
(309) 692-9898
Fax
(309) 692-9055
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036053979 IL Primary

Addresses

Primary practice location

7309 N Knoxville Ave
Peoria, IL 61614-2085

Mailing address

7309 N Knoxville Ave
Peoria, IL 61614-2085
Phone (309) 692-9898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050129000071 IL Practitioner - Urology 7810947611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Urological Group LTDGroup PAC ID 3274434451, 2 clinicians

Practice addresses (Care Compare)

7309 N Knoxville Ave
Suite 1
Peoria, IL 61614-2086
Phone (309) 692-9898

Hospital & facility affiliations

  • Carle Home Care Home health agency, Champaign, IL, CCN 147241
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120
  • Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325
  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection15
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036053979ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peoria Day Surgery Center LTD CurrentSince Sep 1, 1996 Accepting new patients
Midwest Urological Group, LTD. CurrentSince Aug 1, 2006 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Midwest Urological Group, LTD. Past Accepting new patients

Locations

7309 N Knoxville Ave
Peoria, IL 61614
Phone (309) 282-0827

7309 N Knoxville Ave
Ste 1
Peoria, IL 61614
Phone (309) 643-6105

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.105053
  • Direct secure messaging: joseph.banno.1@28977.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1811951072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "309-692-9898",
            "fax_number": "309-692-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142085",
            "telephone_number": "309-692-9898",
            "fax_number": "309-692-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNO",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036053979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.