MARY S BANNON (NP) – Gerontology Nurse Practitioner, NPI 1043392590

MARY S BANNON (NP) is a healthcare provider. based in Waltham, Massachusetts. specializing in Gerontology Nurse Practitioner. They hold the professional credentials NP. They hold a License No. 158347 (MA). The NPI Number for MARY S BANNON (NP) is 1043392590

Main info

Female
39 Years Of Experience
Accepts Medicare Assignment
Name
MARY S BANNON (NP)
NPI
1043392590
Phone
(781) 647-3040
Address
671 MAIN ST
Enumeration Date
20 October 2006
Last Update Date
28 July 2017

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9782963781
Graduation Year
1987 (39 years ago)
PAC ID
2668479551
Group Practice PAC ID
5991016933
Professional Enrollment ID
I20061108000040
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MARY S BANNON (NP)

  • Main Street, Piety Corner, Waltham, Middlesex County, Massachusetts, 02452-6225, United States

    WALTHAM, MA 024510602

    Phone: (781) 647-3040

    Fax: (781) 647-3044

    Type: Location

  • 47 HIGH STREET SUITE 101

    NORTH ANDOVER, MA 01845

    Phone: (978) 685-2460

    Fax: (978) 685-2572

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02451)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991016933View full group profile
NameSpecialtyState
-MA
Nurse PractitionerNJ
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

Is MARY S BANNON (NP) listed with a National Provider Identifier?
Yes — MARY S BANNON (NP) has NPI 1043392590 on file in the registry.
Active or inactive — what applies to MARY S BANNON (NP)?
You should see MARY S BANNON (NP) as active in CMS-hosted NPPES data.
What clinical focus is listed for MARY S BANNON (NP)?
At a glance, MARY S BANNON (NP) is tied to Gerontology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MARY S BANNON (NP)?
Travel planning: use Waltham, Massachusetts as the reference point for MARY S BANNON (NP), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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