HEATHER S BANKS MD
NPI 1093804460
Family Medicine in Boulder, CO

Active since October 12, 2006PECOS EnrolledAccepts Medicare Assignment
5495 ARAPAHOE AVE, BOULDER, CO 80303(720) 848-9200 Get Directions Write a Review

NPPES record last updated: October 30, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 30, 2019, Aug 25, 2019 (2 updates tracked since 2019).

About Heather S Banks Md NPPES

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

HEATHER S BANKS MD (NPI 1093804460) is an individual family medicine provider in Boulder, Colorado, licensed in Colorado (DR.0038923) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Aurora, and is a graduate of Medical College Of Wisconsin (1998).

NPPES Registry Identity

NPI1093804460
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameHEATHER S BANKSCredential: MD
Location Address5495 ARAPAHOE AVEBoulder, CO 80303-1200
Mailing Address6750 Bugle CtBoulder, CO 80301-3869 · (505) 353-2591
Sole ProprietorNo
Medical School CMSMedical College Of WisconsinGraduated 1998
Enumeration DateOctober 12, 2006
Last NPPES UpdateOctober 30, 20192 updates tracked since enumeration
NPI 1093804460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses Licensed in CO · DR.0038923 Licensed in OR · MD24027
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5495 ARAPAHOE AVE, Boulder, CO 80303

Secondary Practice Location 1

Location 112605 E 16th AveAurora, CO 80045-2545 · Phone (720) 848-0000

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Heather S Banks Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870773336
PECOS Enrollment IDI20141112000710
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
151 services112 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
102 services70 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
29 services29 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80303 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers15 claims15 services$15.68 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers16 claims16 services$77.56 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
5495 ARAPAHOE AVE
BOULDER, CO 80303
Physical Therapist (Neurology)
5495 ARAPAHOE AVE
BOULDER, CO 80303
General Acute Care Hospital
5495 ARAPAHOE AVE
BOULDER, CO 80303
Physical Therapist
5495 ARAPAHOE AVE
BOULDER, CO 80303
Psychologist
5495 ARAPAHOE AVE
BOULDER, CO 80303
Family Medicine
5495 ARAPAHOE AVE
BOULDER, CO 80303
Physical Therapist (Orthopedic)
5495 ARAPAHOE AVE
BOULDER, CO 80303
Physical Therapist
5495 ARAPAHOE AVE
BOULDER, CO 80303

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 Heather Banks's NPI number?

The NPI number for Heather Banks is 1093804460. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is Heather Banks located?

Heather Banks practices at 5495 Arapahoe Ave, Boulder, CO 80303. The listed phone number is (720) 848-9200.

What is Heather Banks's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Heather Banks enrolled in Medicare?

Yes. Heather Banks is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Heather Banks accept?

Health plans from Medica list Heather Banks 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 Heather Banks was last updated on October 30, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.