DR. BONITA BANERJEE (D.O.) – Emergency Medicine Physician, NPI 1780767053
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. BONITA BANERJEE (D.O.)
180 MAPLE AVE W
VIENNA, VA 221805727
Phone: (571) 363-3539
Fax: (571) 363-3540
Type: Location
3400 DATA DR
ATTN CREDENTIALING/PAYER ENROLLMENT
RANCHO CORDOVA, CA 956707956
Phone:
Type: Mailing
750 REDWOOD HWY FRONTAGE RD STE 1204
MILL VALLEY, CA 949412483
Phone: (415) 384-4778
Fax: (415) 384-4779
Type: Location
PSC 50 BOX 987
APO, AE 094940010
Phone: (202) 255-4015
Type: Mailing
Albany Medical Center, 43, New Scotland Avenue, Park South, Lark Street, Albany, Albany County, New York, 12208, United States
GRADUATE MEDICAL EDUCATION MC50
ALBANY, NY 122083412
Phone: (516) 238-6464
Type: Location
22, Vista Drive, Village of Scotia, Town of Glenville, Schenectady County, New York, 12302, United States
SCOTIA, NY 123023214
Phone: (516) 238-6464
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-08-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120730000146 | I | Emergency Medicine | VA | TBD |
| I20120802000329 | I | Emergency Medicine | DC | TBD |
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.
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 22180)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MD | |
| - | MD | |
| Internal Medicine | VA | |
| Family Practice | VA | |
| Family Practice | VA | |
| - | MD | |
| - | MD | |
| Family Practice | WV | |
| - | GA | |
| - | MD |
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