Active NPI
Burton Banner, M.D.
- Pediatrics Physician
- Staten Island, NY
National Provider Identifier
1992777999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 124003
- Practice address
- 2281 Victory Blvd
Staten Island, NY 10314-6625 - Phone
- (718) 494-6400
- Fax
- (718) 761-6854
- NPI assigned
- Feb 3, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 124003 | NY | Primary |
Addresses
Primary practice location
2281 Victory Blvd
Staten Island, NY 10314-6625
Mailing address
2281 Victory Blvd
Staten Island, NY 10314-6625
Phone (718) 494-6400
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9688 | Other | GHI HMO INSURANCE | |
| 0096152 | Other | GROUP HEALTH INSURANCE | |
| BB03578110 | Other | NY | EMPIRE BLUE CROSS BLUE SH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20140815000518 | NY | Order and Referring Only - Pediatric Medicine | 5193942191 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124003 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1992777999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2281 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103146625",
"telephone_number": "718-494-6400",
"fax_number": "718-761-6854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2281 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103146625",
"telephone_number": "718-494-6400",
"fax_number": "718-761-6854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNER",
"first_name": "BURTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "124003",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI HMO INSURANCE",
"identifier": "9688",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH INSURANCE",
"identifier": "0096152",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUE CROSS BLUE SH",
"identifier": "BB03578110",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.