NPIMap

Individual provider Active NPI

Dimitrina Banu, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1992031124
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013532 Issued in NY
Practice address
374 Stockholm St
C/O Faculty Practice Management- Suite 1-37 North
Brooklyn, NY 11237-4006
Phone
(718) 963-6551
NPI assigned
Oct 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 055-0031522 VT
Surgical Physician Assistant 363AS0400X C0004445 MD
Physician Assistant 363A00000X 013532 NY Primary

Addresses

Primary practice location

374 Stockholm St
C/O Faculty Practice Management- Suite 1-37 North
Brooklyn, NY 11237-4006

Mailing address

1800 Orleans St
Sheikh Zayed Tower Room 6118
Baltimore, MD 21287-0010
Phone (914) 707-2138

Other practice location 1

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-4531

Other identifiers 1

IdentifierTypeStateIssuer
03210226MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091106000498 NY Practitioner - Physician Assistant 8426196775 Reassigns benefits to 1 organization
I20211111002309 VT Practitioner - Physician Assistant 8426196775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

1 S Prospect St
Burlington, VT 05401-5505
Phone (802) 847-0000

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Hospital & facility affiliations

  • Uvmhn Home Health and Hospice Home health agency, Colchester, VT, CCN 477000
  • Bayada Home Health Care, Inc. Home health agency, Rutland, VT, CCN 477019
  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
  • Central Vermont Medical Center Hospital, Barre, VT, CCN 470001
  • Porter Hospital Inc Hospital, Middlebury, VT, CCN 471307
  • Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013532NYMDChiropractor
C0004445MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Nov 1, 2021 Accepting new patients
Alice Hyde Medical Center Physician Assistant CurrentSince Jun 1, 2014 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

1800 Orleans St
Rm 6118
Baltimore, MD 21287

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

1 S Prospect St
#1
Burlington, VT 05401

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

Interoperability endpoints

  • Direct secure messaging: dbanu458246@direct.uvmhealth.org

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1992031124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "address_2": "SHEIKH ZAYED TOWER ROOM 6118",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "914-707-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 STOCKHOLM ST",
            "address_2": "C/O FACULTY PRACTICE MANAGEMENT- SUITE 1-37 NORTH",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374006",
            "telephone_number": "718-963-6551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 S Prospect St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054013456",
            "country_code": "US",
            "telephone_number": "802-847-4531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANU",
        "first_name": "DIMITRINA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-22",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0031522",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0004445",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03210226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.