Dante Atienza Banta, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

00A440791 Issued in CA

Practice address

875 N Western Ave
Los Angeles, CA 90029-3759

Phone

(323) 258-7568

Fax

(323) 258-7498

NPI assigned

Nov 20, 2006

Last updated

Aug 2, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

General PracticeAlso: Family Practice

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Quiet Embrace Hospice Care Hospice, Van Nuys, CA, CCN B31793

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Allied Care Hospice Inc

  • Community Based Hospice Care Agency
  • Rancho Cucamonga, CA
  • NPI 1508278755

  Contracted Managing Employee

  CMS ownership
• Mission Hospice & Palliative Care Inc

  • Community Based Hospice Care Agency
  • Van Nuys, CA
  • NPI 1457965451

  Contracted Managing Employee

  CMS ownership

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.

• Dante a. Banta, M.D., Inc.

  dba Clinica Western

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1215100417
  Medicare reassignment NPD Authorized official
• Cha Hollywood Medical Center, LP

  dba Hollywood Presbyterian Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1922033547
  NPD (past)
• Dignity Health

  dba Mercy Hospital

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1104981661
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mission Hospice & Palliative Care Inc

  • Community Based Hospice Care Agency
  • Van Nuys, CA
  • NPI 1457965451
  Care Compare affiliation

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1912071085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-258-7568",
            "fax_number": "323-258-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 N WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900293759",
            "telephone_number": "323-258-7568",
            "fax_number": "323-258-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTA",
        "first_name": "DANTE",
        "middle_name": "ATIENZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "00A440791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A440791",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00A440791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric J Bansal, M.D.
• Jagan Bansal, M.D.
• Maneesh A Bansal, M.D.
• Manvi Bansal, M.D.
• Sumati Bansal, D.O.
• Paul E. Banta, M.D.
• Veronica M Banta, MD
• Warren Banta, MD
• Christian Bantasan
• Eliza Bantolo, PT

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.