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BANNER HEALTH PHYSICIANS WEST LLC
NPI 1063778728
Clinic/Center - Multi-Specialty in Casper, WY

Active since April 06, 2012CLIA Certified · 5 labs
1020 E 2ND ST STE 201, CASPER, WY 82601(307) 233-0250 Get Directions Write a Review

NPPES record last updated: April 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 13, 2026, Aug 4, 2022, Dec 30, 2021 (3 updates tracked since 2021).

About Banner Health Physicians West Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANNER HEALTH PHYSICIANS WEST LLC (NPI 1063778728) is a healthcare organization registered as a multi-specialty in Casper, Wyoming and active in the NPI registry since April 2012. The organization holds 5 active CLIA laboratory certificates, maintains 29 additional practice locations, and lists Shiva Birdi, Ceo Bmg, as its authorized official.

NPPES Registry Identity

NPI1063778728
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBANNER HEALTH PHYSICIANS WEST LLC
Location Address1020 E 2ND ST STE 201Casper, WY 82601-2955
Mailing Address2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Phone(307) 233-0250
Organization SubpartYesParent: Banner Medical Group
Authorized OfficialShiva BirdiCeo Bmg · (602) 747-4000
Enumeration DateApril 6, 2012
Last NPPES UpdateApril 13, 20263 updates tracked since enumeration
NPPES CertifiedApril 13, 2026
✔ NPI 1063778728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1020 E 2ND ST STE 201, Casper, WY 82601
Open in Google Maps ↗

Secondary Practice Locations 29

Location 13632 American Way Ste ACasper, WY 82604-3164 · Phone (307) 234-6765
Location 23632 American Way Ste BCasper, WY 82604-3164 · Phone (307) 233-7300
Location 33955 E 12th StCasper, WY 82609-3114 · Phone (307) 577-3045
Location 4201 14th StWheatland, WY 82201-3201 · Phone (307) 322-3636
Location 52300 Gasser RdRiverton, WY 82501-2204 · Phone (307) 266-4000
Location 6255 N 30th StLaramie, WY 82072-5140 · Phone (307) 237-5047
Location 71230 E 1st StCasper, WY 82601-2704 · Phone (307) 233-0250
Location 81141 Wilkins CirCasper, WY 82601-1332 · Phone (307) 472-3700
Location 91115 Lane 12Lovell, WY 82431-9537 · Phone (307) 347-2555
Location 101106 Big Horn AveWorland, WY 82401-2803 · Phone (307) 347-8801
Location 11110 N 2nd StDouglas, WY 82633-2127 · Phone (307) 237-5047
Location 121020 S Conwell StCasper, WY 82601-3921 · Phone (307) 265-8300
Location 131405 Howell AveWorland, WY 82401-4127 · Phone (307) 347-2555
Location 148195 State Highway 789Lander, WY 82520-2942 · Phone (307) 237-5047
Location 151950 S Beverly StCasper, WY 82609-3348 · Phone (307) 224-9843
Location 16400 S 15th St Ste 101Worland, WY 82401-3531 · Phone (307) 347-3221
Location 172000 Campbell DrTorrington, WY 82240-1528 · Phone (307) 532-4181
Location 184041 S Poplar StCasper, WY 82601-5928 · Phone (307) 266-0000
Location 19419 S Washington St Ste 102Casper, WY 82601-2951 · Phone (307) 577-2592
Location 20419 S Washington St Ste 201ACasper, WY 82601-2951 · Phone (307) 237-5047
Location 21419 S Washington St Ste 201BCasper, WY 82601-2951 · Phone (307) 577-0477
Location 22419 S Washington St Ste 201CCasper, WY 82601-2951 · Phone (307) 577-2592
Location 23419 S Washington St Ste 201DCasper, WY 82601-2951 · Phone (307) 233-0286
Location 244305 S Poplar StCasper, WY 82601-6106 · Phone (800) 304-7152
Location 2560 Magnolia StCasper, WY 82604-4035 · Phone (307) 234-9381
Location 266550 E 2nd StCasper, WY 82609-4321 · Phone (307) 995-8100
Location 276600 E 2nd St Ste CCasper, WY 82609-4348 · Phone (307) 473-6768
Location 286600 E 2nd St Ste DCasper, WY 82609-4348 · Phone (307) 473-6768
Location 29777 Avenue HPowell, WY 82435-2260 · Phone (307) 347-5810

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Banner Health Physicians West Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateWyomingEnrollment IDO20120607000123Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

119

Medicare enrollment records show 119 clinicians reassign Medicare billing to Banner Health Physicians West LLC, which bills Medicare for the services they deliver. Of these, 29 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 21

Family Practice33
Nurse Practitioner23
General Surgery17
Obstetrics/Gynecology10
Cardiovascular Disease (Cardiology)6
Critical Care (Intensivists)5
Neurosurgery4
Orthopedic Surgery3
13 other specialties18

Nearest to this location (20)

See all 119
Joseph Monfre, M.D.
Cardiovascular Disease (Cardiology)
NPI 1568781045
805 E 2ND ST STE 3
Casper, WY 82601
(307) 237-2300
✔ PECOS✔ Accepts Medicare0.2 mi
Benjamin Kautza, M.D.
General Surgery
NPI 1407083132
1233 E 2ND ST
Casper, WY 82601
(414) 719-2959
✔ PECOS✔ Accepts Medicare0.2 mi
Jack Malone, DO
Critical Care (Intensivists)
NPI 1629561196
1233 E 2ND ST
Casper, WY 82601
(307) 577-7201
✔ PECOS✔ Accepts Medicare0.2 mi
Brynn Robinson, APRN
Nurse Practitioner
NPI 1326295858
419 S WASHINGTON ST SUITE 102
Casper, WY 82601
(307) 577-4220
✔ PECOS✔ Accepts Medicare0.2 mi
Thomas Adams, MD
General Surgery
NPI 1013573575
419 S WASHINGTON ST STE 200
Casper, WY 82601
(307) 577-4220
✔ PECOS✔ Accepts Medicare0.2 mi
Aimee Gough, MD
General Surgery
NPI 1902161664
419 S WASHINGTON ST STE 200
Casper, WY 82601
(307) 577-4220
✔ PECOS✔ Accepts Medicare0.2 mi
Hillary Morrison, D.O.
General Surgery
NPI 1972952307
419 S WASHINGTON ST STE 200
Casper, WY 82601
(307) 577-4220
✔ PECOS✔ Accepts Medicare0.2 mi
Stephany Sedmak
Nurse Practitioner
NPI 1780942573
419 S WASHINGTON ST STE 200
Casper, WY 82601
(307) 253-0415
✔ PECOS✔ Accepts Medicare0.2 mi
Monica Janssen
Nurse Practitioner
NPI 1356712293
167 S CONWELL ST STE #3
Casper, WY 82601
(307) 233-0246
✔ PECOS✔ Accepts Medicare0.2 mi
Mesha Dunn, M.D.
Family Practice
NPI 1235491341
1522 E A ST
Casper, WY 82601
(307) 234-6161
✔ PECOS✔ Accepts Medicare0.4 mi
Ismaeel Bakhsh, M.D.
Pediatric Medicine
NPI 1184243685
1020 CONWELL ST.
Casper, WY 82601
(516) 808-1917
✔ PECOS0.7 mi
Alexandra Brodka, MD
Family Practice
NPI 1356911754
1020 S CONWELL ST
Casper, WY 82601
(307) 265-8300
✔ PECOS✔ Accepts Medicare0.7 mi
Christina Elize Jara, M.D.
Internal Medicine
NPI 1386199958
1020 S CONWELL ST
Casper, WY 82601
(307) 265-8300
✔ PECOS✔ Accepts Medicare0.7 mi
Megan Makelky
Nurse Practitioner
NPI 1114568292
1020 S CONWELL ST
Casper, WY 82601
(307) 265-8300
✔ PECOS✔ Accepts Medicare0.7 mi
Marjorie Wells, M.D.
Family Practice
NPI 1780698431
1020 S. CONWELL STREET
Casper, WY 82601
(307) 265-8300
✔ PECOS✔ Accepts Medicare0.7 mi
Jennifer Lee, APRN
Nurse Practitioner
NPI 1841707932
4140 CENTENNIAL HILLS BLVD STE A
Casper, WY 82609
(307) 265-7205
✔ PECOS✔ Accepts Medicare2.4 mi
Angela Booth, APRN
Nurse Practitioner
NPI 1477003192
3632 AMERICAN WAY
Casper, WY 82604
(307) 234-6765
✔ PECOS✔ Accepts Medicare3.5 mi
Maxim Salva, MD
Family Practice
NPI 1932395944
3632 AMERICAN WAY
Casper, WY 82604
(307) 234-6765
✔ PECOS✔ Accepts Medicare3.6 mi
Emily Tutt, DO
Family Practice
NPI 1962082784
3632 AMERICAN WAY
Casper, WY 82604
(307) 234-6765
✔ PECOS✔ Accepts Medicare3.6 mi
Kevin Helling, M.D.
General Surgery
NPI 1730383654
6600 E 2ND ST STE A
Casper, WY 82609
(307) 333-4363
✔ PECOS✔ Accepts Medicare4.4 mi
See all 119 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 53D1026465

Banner Health Physicians West LLC · Worland, WY
Active · expires Sep 15, 2028
CLIA Number53D1026465
Laboratory TypePhysician Office
Certificate Effective DateSeptember 16, 2026
Certificate Expiration DateSeptember 15, 2028
Laboratory DirectorDiane L. Noton
Laboratory Phone(307) 347-2555
Laboratory LocationBanner Health Physicians West LLC1405 Howell Ave, Worland, WY 82401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 53D2039661

Banner Health Physicians West LLC · Casper, WY
Active · expires Mar 25, 2028
CLIA Number53D2039661
Laboratory TypePhysician Office
Certificate Effective DateMarch 26, 2026
Certificate Expiration DateMarch 25, 2028
Laboratory DirectorTatiana Rupp
Laboratory Phone(307) 473-6768
Laboratory LocationBanner Health Physicians West LLC6600 E 2nd Street, Casper, WY 82609
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 53D0925425

Banner Health Physicians West LLC · Casper, WY
Active · expires Sep 27, 2027
CLIA Number53D0925425
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2025
Certificate Expiration DateSeptember 27, 2027
Laboratory DirectorJames M. Davidson
Laboratory Phone(307) 265-8300
Laboratory LocationBanner Health Physicians West LLC1020 S Conwell, Casper, WY 82601
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 53D2099145

Banner Health Physicians West LLC · Casper, WY
Active · expires Sep 27, 2027
CLIA Number53D2099145
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2025
Certificate Expiration DateSeptember 27, 2027
Laboratory DirectorAngela L. Booth
Laboratory Phone(307) 233-7300
Laboratory LocationBanner Health Physicians West LLC3632 American Way, Casper, WY 82604
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 53D2198018

Banner Health Physicians West LLC · Worland, WY
Active · expires Oct 28, 2026
CLIA Number53D2198018
Laboratory TypePhysician Office
Certificate Effective DateOctober 29, 2024
Certificate Expiration DateOctober 28, 2026
Laboratory DirectorSameh G. Abuerreish
Laboratory Phone(307) 347-6937
Laboratory LocationBanner Health Physicians West LLC400 S 15th St, Ste 101, Worland, WY 82401
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Banner Health Physicians West LLC's NPI number?

The NPI number for Banner Health Physicians West LLC is 1063778728. It was assigned to this organization in the NPPES registry on April 6, 2012.

Where is Banner Health Physicians West LLC located?

Banner Health Physicians West LLC is located at 1020 E 2nd St Ste 201, Casper, WY 82601. The listed phone number is (307) 233-0250.

What is Banner Health Physicians West LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Banner Health Physicians West LLC enrolled in Medicare?

Yes. Banner Health Physicians West LLC is registered in the Medicare PECOS enrollment system.

When is Banner Health Physicians West LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Wyoming, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Banner Health Physicians West LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 119 clinicians in 21 Medicare specialties reassign their Medicare billing to Banner Health Physicians West LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (33), Nurse Practitioner (23) and General Surgery (17). Of these, 29 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Banner Health Physicians West LLC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Banner Health Physicians West LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan and Blue Cross Blue Shield of Wyoming list Banner Health Physicians West LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Banner Health Physicians West LLC was last updated on April 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.