DR. KRISTA MAUREEN BANNON (M.D.) – Surgery Physician, NPI 1184886533

DR. KRISTA MAUREEN BANNON (M.D.) is a healthcare provider. based in Southfield, Michigan. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. 4301092722 (MI). The NPI Number for DR. KRISTA MAUREEN BANNON (M.D.) is 1184886533

Main info

Female
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
DR. KRISTA MAUREEN BANNON (M.D.)
NPI
1184886533
Phone
(248) 849-3091
Address
16001 W 9 Mile Rd
Enumeration Date
26 June 2008
Last Update Date
28 March 2019

Doctor Profile

Medical School Name
MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Secondary Phone
2483449110
Graduation Year
2008 (18 years ago)
PAC ID
5193072353
Group Practice PAC ID
5496750523
Professional Enrollment ID
I20180718003187
Address ID
MI480441161MA17900RDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

1,444 GENERAL SURGERY in MI

Provider Addresses for DR. KRISTA MAUREEN BANNON (M.D.)

  • 16001 W 9 Mile Rd

    Southfield, MI 48075

    Phone: (248) 849-3091

    Type: Location

  • 300, Riverfront Drive, West Side Industrial Park, Detroit, Wayne County, Michigan, 48226, United States

    UNIT 11B

    DETROIT, MI 482264516

    Phone: (312) 282-3182

    Type: Mailing

  • 260, South Livernois Road, Rochester Hills, Oakland County, Michigan, 48307, United States

    ROCHESTER HILLS, MI 483072593

    Phone: (248) 855-5355

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $2,165.

Total Amount is formed as General ($2,165) + Research ($0) + Ownership ($0) = $2,165.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: ConvaTec Inc. ($1,573).

Total Amount

$2,165

General + Research + Ownership

Payments

20

Total payment records

General Amount

$2,165

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-07-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180718003187IGeneral SurgeryMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93970Ultrasound study of arm or leg veins with compression and maneuvers228159$0
93971Ultrasound study of one arm or leg veins with compression and maneuvers206121$0
76942Ultrasonic guidance for needle placement13979$0
36471Injection of chemical agent into multiple incompetent veins of leg13177$0
99204New patient office or other outpatient visit, 45-59 minutes110110$0
View full utilization report →

Insurance plans in this area (ZIP 48075)

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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: 5496750523View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineMI
Occupational Therapist In Private PracticeMI
Diagnostic Radiology, Interventional RadiologyMI
Interventional Radiology, Diagnostic RadiologyMI
Diagnostic Radiology, Interventional RadiologyMI

Reviews

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Frequently asked questions

How is DR. KRISTA MAUREEN BANNON (M.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. KRISTA MAUREEN BANNON (M.D.) with NPI 1184886533.
Does CMS list DR. KRISTA MAUREEN BANNON (M.D.) as active?
Yes — DR. KRISTA MAUREEN BANNON (M.D.) is active in the NPI listing used on this page.
What is DR. KRISTA MAUREEN BANNON (M.D.) best known for clinically?
Directory data describes DR. KRISTA MAUREEN BANNON (M.D.) with Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. KRISTA MAUREEN BANNON (M.D.)?
DR. KRISTA MAUREEN BANNON (M.D.)'s geographic hint is Southfield, Michigan in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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