Elyse Banister, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003056 Issued in PA

Practice address

8900 SE 165TH Mulberry LN
The Villages, FL 32162-5884

Phone

(352) 674-5000

NPI assigned

Jun 26, 2015

Last updated

Aug 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1912389891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LN",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625884",
            "telephone_number": "352-674-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANISTER",
        "first_name": "ELYSE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003042",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bo Bagenholm, MD
• Branda Bailey, PTA
• Sergio Labial Balingit Jr., MD
• Madhusudhan Reddy Banda, MD
• William Lake Bandy, DPT
• Kelley J Bannerman, PTA
• Thomas Paul Baranek, MA CCC-A
• Effie Darlene Barba, A.R.N.P.
• Austin Barfield
• Brenda Vagenheim Barnes, DC

• Optometrist in The Villages, FL
• Providers in The Villages, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.