ALI BANAIE M.D.
NPI 1386613206
Internal Medicine - Gastroenterology in La Mesa, CA

Q: What is Ali Banaie's NPI number?

The NPI number for Ali Banaie is 1386613206. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Ali Banaie's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Ali Banaie was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since March 14, 2006PECOS Enrolled

75/100

CMS Quality Rating

8860 CENTER DRIVE, SUITE 420, LA MESA, CA 91942(619) 469-5400(619) 464-1311 Get Directions Write a Review

NPPES record last updated: March 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 21, 2023, Nov 11, 2020, Feb 7, 2017 (3 updates tracked since 2017).

On this page

About Ali Banaie M.d. NPPES

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

ALI BANAIE M.D. (NPI 1386613206) is an individual gastroenterology provider in La Mesa, California, licensed in California (A87308) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Great Falls, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1386613206

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameALI BANAIECredential: M.D.

Location Address8860 CENTER DRIVE, SUITE 420La Mesa, CA 91942-3020

Mailing Address8860 Center Drive, Suite 420La Mesa, CA 91942-3020 · (619) 469-5400 · Fax (619) 464-1311

Phone(619) 469-5400

Fax(619) 464-1311

Sole ProprietorYes

Medical School CMSOtherGraduated 1998

Enumeration DateMarch 14, 2006

Last NPPES UpdateMarch 21, 20233 updates tracked since enumeration

NPPES CertifiedMarch 21, 2023

✔ NPI 1386613206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Licenses✔ Licensed in CA · A87308✔ Licensed in MT · 98403

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

8860 CENTER DRIVE, La Mesa, CA 91942

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Secondary Practice Location 1

Location 11401 25th St SGreat Falls, MT 59405-5183 · Phone (406) 731-8888 · Fax (406) 731-8318

Other Identifiers 1

Medicaid00A873080CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ali Banaie M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870573561

PECOS Enrollment IDI20040723000631

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 20

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

294 services272 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

192 services182 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

181 services102 patients

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500

Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.

147 services147 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

146 services146 patients

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.

134 services117 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

88 services88 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

70 services70 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

64 services62 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.

51 services50 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

36 services36 patients

Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43255

This procedure involves using a flexible tube with a light, called an endoscope, to examine and treat bleeding in the esophagus, stomach, or upper small bowel. It's a safe, effective way to control bleeding and ensure your digestive health.

30 services30 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

27 services27 patients

Incision of pancreatic outlet using a flexible endoscope 43262

This procedure involves a small cut in the outlet of the pancreas using a flexible tube with a camera, called an endoscope. It helps doctors diagnose and treat conditions affecting the pancreas, enhancing patient comfort and recovery.

26 services25 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

25 services25 patients

Insertion of stomach tube using a flexible endoscope 43246

This procedure involves the use of a flexible endoscope, a thin tube with a light and camera, to insert a stomach tube. It helps doctors view and access your stomach without surgery. It's typically performed under sedation to ensure comfort.

20 services20 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

18 services15 patients

Exam of common bile and/or pancreatic duct using a flexible endoscope 43273

This procedure, known as an ERCP, involves a flexible tube with a camera, called an endoscope, being gently passed down your throat to examine your common bile or pancreatic duct. It helps doctors diagnose and treat conditions affecting these areas.

17 services16 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

12 services12 patients

Injection of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43236

This procedure involves a flexible tube, called an endoscope, which is passed through your mouth to examine your esophagus, stomach, and upper small bowel. A special needle is used to inject medication or other substances directly into these areas.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91942 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

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

65%537 patients4/55-star benchmark: 85%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

100%575 patients5/55-star benchmark: 99%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

79%426 patients4/55-star benchmark: 99%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

25%683 patients2/55-star benchmark: 97%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

38%426 patients2/55-star benchmark: 90%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

37%836 patients2/55-star benchmark: 97%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

46%345 patients3/55-star benchmark: 88%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 94% · 662 patients

Patients tobacco: 87% · 662 patients

30%63 patients2/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

78%683 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

6%683 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

27%683 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 4

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

KAVEH BAGHERI M.D.

Internal Medicine (Pulmonary Disease)

8860 CENTER DRIVE, SUITE 240
LA MESA, CA 91942

San Diego County (619) 589-2535

BANAIE MEDICAL CORPORATION

Internal Medicine (Gastroenterology)

8860 CENTER DRIVE, SUITE 420
LA MESA, CA 91942

San Diego County (619) 469-5400

ROBERT A BRENNER

Internal Medicine (Gastroenterology)

8860 CENTER DRIVE, SUITE 420
LA MESA, CA 91942

San Diego County (619) 469-5400

DR. LUIS C. CAJAS-MONSON M.D.

Surgery (Vascular Surgery)

8860 CENTER DRIVE, SUITE 450
LA MESA, CA 91942

San Diego County (619) 460-6200

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 Ali Banaie's NPI number?

The NPI number for Ali Banaie is 1386613206. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Where is Ali Banaie located?

Ali Banaie practices at 8860 Center Drive Suite 420, La Mesa, CA 91942. The listed phone number is (619) 469-5400.

What is Ali Banaie's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Ali Banaie enrolled in Medicare?

Yes. Ali Banaie is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ali Banaie was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.