MOUSTAFA BANNA MD
NPI 1003009861
Internal Medicine - Cardiovascular Disease in Peoria, AZ


Quality Rating: 92.5 out of 100 score

NPI Status: Active since August 23, 2007

Contact Information

13460 N 94TH DR STE J1
PEORIA, AZ
ZIP 85381
Phone: (623) 876-8816
Fax: (623) 298-0168

Get Directions Reviews

  • Individual
  • Male
  • Years of Experience 19
  • Internal Medicine
  • Cardiovascular Disease
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About MOUSTAFA BANNA

Moustafa Banna is an internist established in Peoria, Arizona and his medical specialization is Internal Medicine with a focus in cardiovascular disease with more than 19 years of experience. He graduated from University Of Cincinnati College Of Medicine in 2005. The healthcare provider is registered in the NPI registry with number 1003009861 assigned on August 2007. The practitioner's primary taxonomy code is 207RC0000X with license number 45263 (AZ). The provider is registered as an individual and his NPI record was last updated January 2024.

NPI1003009861
Provider NameMOUSTAFA BANNA MD
Location Address13460 N 94TH DR STE J1 PEORIA, AZ 85381
Location Phone(623) 876-8816
Mailing Address13460 N 94TH DR STE J1 PEORIA, AZ 85381
GenderMale
Entity TypeIndividual
Medical School NameUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year2005
Is Sole Proprietor?No
Enumeration Date08-23-2007
Last Update Date01-11-2024
Code Navigator

An internist like Moustafa Banna is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Moustafa Banna is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 92.5, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The typical physician office visit costs for Medicare beneficiaries in this area are: $33.05 for a new patient copayment and $25.51 for an established patient copayment.

Location Map

Mailing Address

13460 N 94TH DR STE J1
PEORIA, AZ
ZIP 85381
Phone: (623) 876-8816
Fax: (623) 298-0168


Secondary Locations

  • 5651 W Talavi Blvd
    Glendale, AZ 85306
    (623) 876-8816

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Cardiovascular Disease

Taxonomy Code207RC0000X
TypeAllopathic & Osteopathic Physicians
License No.45263
License StateAZ
Taxonomy DescriptionAn internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Insurance Plans Accepted

The NPI profile data suggests this provider may be accepting health plans from these insurance companies or healthcare programs:

  • Medicaid
  • Medicare

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
040629MEDICAID (05)AZ 

PECOS Enrollment and Medicare Participation Status

Moustafa Banna is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1658525894

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20130215000495

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 85381 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $132.23
  • Minimum New Patient Price $57.31
  • Maximum New Patient Price $174.67
  • Average New Patient Copayment $33.05
  • Minimum New Patient Copayment $14.32
  • Maximum New Patient Copayment $43.66

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $102.07
  • Minimum Established Patient Price $17.74
  • Maximum Established Patient Price $142.64
  • Average Established Patient Copayment $25.51
  • Minimum Established Patient Copayment $4.43
  • Maximum Established Patient Copayment $35.66

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 92.5 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 100

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 20

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 389

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 184

    Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)

  • 78

    Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)

  • 22

    Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers (HCPCS:93970)

  • 17

    Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)

  • 15

    Exercise or drug-induced heart and blood vessel stress test with ekg monitoring, physician interpretation and report (HCPCS:93018)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Moustafa Banna is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
BANNER THUNDERBIRD MEDICAL CENTER5555 WEST THUNDERBIRD ROAD
GLENDALE, AZ 85306
(602) 865-4470Acute Care Hospitals
BANNER ESTRELLA MEDICAL CENTER9201 WEST THOMAS ROAD
PHOENIX, AZ 85037
(623) 327-4000Acute Care Hospitals

Reviews for MOUSTAFA BANNA MD

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003009861
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20030018812
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 0 + 1 + 8 + 8 + 1 + 2 + 24 = 49
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 49 = 11

The NPI number 1003009861 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1649389156JOSEPH A CAPLAN MD PC
Organization
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1013480771MR. MATTHEW S BURROWS APRN-NP, AGACNP-BC
Individual
Nurse Practitioner (Acute Care)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1215933957 JEFFREY M GREENBERG MD
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1326044025 MARC A KATES DO
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1346238425 JOSEPH A CAPLAN MD
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1275521346 CHRISTOPHER G MACKEY DO
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1528033917 JESSE S SETHI MD
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1144298936DR. NORMAN R. SHAIA M.D.
Individual
Internal Medicine (Interventional Cardiology)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1598733651 NISHA L BHATIA M.D.
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1376592071DR. AZIMUDDIN TAREQ KHAWAJA MD
Individual
Internal Medicine (Interventional Cardiology)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1992817910DR. PATRICK M QUINN DO
Individual
Internal Medicine (Cardiovascular Disease)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1134241037MRS. KARI LYN SCHRANK NP
Individual
Nurse Practitioner (Adult Health)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1124249560DR. PAUL D HAAS MD
Individual
Internal Medicine (Clinical Cardiac Electrophysiology)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1588853238 SARAH C. BARR PA-C
Individual
Physician Assistant (Medical)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1275800252 JAMIE R BAIR PA-C
Individual
Physician Assistant (Medical)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1669725685 LAURA MARINONE PC-C
Individual
Physician Assistant (Medical)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1093250870MISS JENNA LEIGH VOLSTROMER AGNP
Individual
Nurse Practitioner (Gerontology)13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1437392750 DANIEL LEVI SCHIPPER PA-C
Individual
Physician Assistant13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1841765435MS. KARA E SEABROOK PA-C
Individual
Physician Assistant13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816
1770958449MRS. ANDREA LOREN WILLCOX PA-C
Individual
Physician Assistant13460 N 94TH DR STE J1
PEORIA, AZ 85381
(623) 876-8816

Frequently Asked Questions

What is Moustafa Banna MD NPI number?

The NPI number assigned to this healthcare provider is 1003009861, enumerated in the NPI registry as an "individual" on August 23, 2007

Where is the provider located?

The provider is located at 13460 N 94th Dr Ste J1 Peoria, Az 85381 and the phone number is (623) 876-8816

What is the provider specialty code?

The provider's speciality is Internal Medicine with taxonomy code 207RC0000X with a focus in Cardiovascular Disease

How many years of experience does Moustafa Banna MD have?

The provider has more than 19 years of experience. He graduated from University Of Cincinnati College Of Medicine in 2005.

What insurance does Moustafa Banna MD accept?

The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Is Moustafa Banna MD registered in PECOS?

Yes, as of February 16, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What are Moustafa Banna MD Quality Ratings?

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

How much is a visit to Moustafa Banna MD?

Medicare beneficiaries should expect a typical cost of $132.23 with an average copayment of $33.05 for new patient appointments. Established patients should expect a typical charge of $102.07 and an average copayment of 25.51. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Moustafa Banna MD?

The most common procedures or services performed by this practitioner are: Routine ekg using at least 12 leads including interpretation and report, Nuclear medicine study of vessels of heart using drugs or exercise multiple studies, Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function, Ultrasound scan of veins of both arms or legs including assessment of compression and functional maneuvers, Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck and Exercise or drug-induced heart and blood vessel stress test with ekg monitoring, physician interpretation and report.

Is Moustafa Banna MD affiliated to any hospitals?

The practitioner is affiliated to the following hospital(s): BANNER THUNDERBIRD MEDICAL CENTER and BANNER ESTRELLA MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

This NPI record was last updated on August 23, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.