Maureen Theresa Banta, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101057222 Issued in VA

Practice address

2500 N Van Dorn St Ste 102
Alexandria, VA 22302-1601

Phone

(703) 933-0555

NPI assigned

Oct 23, 2006

Reactivated

Nov 17, 2017

Last updated

Nov 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maureen.banta.1@8042.direct.athenahealth.com

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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  DC, Pediatrics

  Medicare reassignment NPD
• Van Dorn Pediatrics, PC

  • Primary Care Clinic/Center
  • Alexandria, VA
  • NPI 1639379159
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Pulmonologists, PC

  • Pulmonary Disease Physician
  • Gaithersburg, MD
  • NPI 1245270719
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668816000000",
    "number": "1871676122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 32ND ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152309",
            "telephone_number": "301-922-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N VAN DORN ST STE 102",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021601",
            "telephone_number": "703-933-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4808 Moorland Ln Ste 109",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208146131",
            "country_code": "US",
            "telephone_number": "301-654-9476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANTA",
        "first_name": "MAUREEN",
        "middle_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-11-19",
        "certification_date": "2022-11-19",
        "deactivation_date": "2017-11-13",
        "reactivation_date": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0092143",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101057222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia E Bangura, PA-C
• Oluwaseyi Banjo, NP
• Beth A Banker, FNP
• Jaelynn Banks
• Robert Banks
• Nettia Banton
• Banyan Counseling Center, Inc.
• Karissa Barachie, DNP, NP
• Lesley Barajas
• Francisco Javier Baralt Miro

• Pediatrics Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.