Active NPI
Vivian Banh, DO
- Anesthesiology Physician
- Santa Cruz, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 20A22334
- Practice address
- 1555 Soquel Dr
Santa Cruz, CA 95065-1705 - Phone
- (831) 462-7800
- NPI assigned
- Mar 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 64268 | NY | |
| Anesthesiology Physician | 207L00000X | 20A22334 | CA | Primary |
Addresses
Primary practice location
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Mailing address
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone (831) 462-7800
Other practice location 1
47 New Scotland Ave
Albany, NY 12208-3412
Phone (518) 262-4302
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240912001625 | CA | Practitioner - Anesthesiology | 6901346311 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Medical Group of Santa Cruz Inc
Practice addresses (Care Compare)
1555 Soquel Dr
Santa Cruz, CA 95065-1705
Phone (831) 462-7700
Hospital & facility affiliations
- Dominican Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22334 | CA | MD | Mental Health Counselor |
| 20A22334 | CA | MD | Anesthesiology Physician |
| 64268 | NY | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Medical Group of Santa Cruz, Inc. | Anesthesiology | Current | Accepting new patients |
Locations
1555 Soquel Dr
Santa Cruz, CA 95065
Phone (831) 462-7700
Interoperability endpoints
- vbanh22320@albanymed.direct-ci.com
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Santa Cruz, CA
- NPI 1871541144
Anesthesiology, CA
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717718400000",
"number": "1992332662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 SOQUEL DR",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651705",
"telephone_number": "831-462-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 SOQUEL DR",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950651705",
"telephone_number": "831-462-7800"
}
],
"practiceLocations": [
{
"address_1": "47 New Scotland Ave",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122083412",
"country_code": "US",
"telephone_number": "518-262-4302",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BANH",
"first_name": "VIVIAN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-24",
"last_updated": "2024-06-07",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "64268",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "20A22334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.
- 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.