Active NPI
Wade L Banker, MD
- Diagnostic Radiology Physician
- Cleveland, OH
National Provider Identifier
1891800082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35074019
- Practice address
- 11100 Euclid Ave
Cleveland, OH 44106-1716 - Phone
- (216) 844-1700
- NPI assigned
- Aug 20, 2006
- Last updated
- Sep 25, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 35074019 | OH | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 19652 | MS | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 35074019 | OH |
Addresses
Primary practice location
11100 Euclid Ave
Cleveland, OH 44106-1716
Mailing address
24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714
Phone (216) 844-1700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2285861 | Medicaid | OH | |
| 300002000 | Other | MS | MEDICARE |
| 512G700003 | Other | MS | MS MEDICARE - GROUP |
| P00393376 | Other | MS | RAILROAD MEDICARE |
| 08059068 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19652 | MS | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Radadvantage a Professional Corporation | Diagnostic Radiology | Past | Accepting new patients |
| The Cleveland Clinic Foundation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- General Acute Care Hospital
- Cleveland, OH
- NPI 1679525919
-
- Diagnostic Radiology Physician
- Phoenix, AZ
- NPI 1376719666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1891800082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24701 EUCLID AVE",
"address_2": "3RD FLOOR",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171714",
"telephone_number": "216-844-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "216-844-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANKER",
"first_name": "WADE",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35074019",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MS",
"license": "19652",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "OH",
"license": "35074019",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2285861",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "300002000",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS MEDICARE - GROUP",
"identifier": "512G700003",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00393376",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08059068",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.