DR. VANITHA BANAJJAR REVANASIDDAPPA MD
NPI 1669856217
Obstetrics & Gynecology in Charlotte, NC

Q: What is Vanitha Banajjar Revanasiddappa's NPI number?

The NPI number for Vanitha Banajjar Revanasiddappa is 1669856217. It was assigned to this individual provider in the NPPES registry on July 14, 2015. The provider is also known as Dr. Vanitha Banajjar MD.

Q: What is Vanitha Banajjar Revanasiddappa's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since July 14, 2015PECOS EnrolledAccepts Medicare Assignment

1718 E 4TH ST STE 907, CHARLOTTE, NC 28204(704) 372-4000(704) 334-4855 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 9, 2025, May 12, 2020, Jul 15, 2019 (3 updates tracked since 2019).

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About Dr. Vanitha Banajjar Revanasiddappa Md NPPES

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

DR. VANITHA BANAJJAR REVANASIDDAPPA MD (NPI 1669856217) is an individual obstetrics & gynecology provider in Charlotte, North Carolina, licensed in North Carolina (2025-01298) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1669856217

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameDR. VANITHA BANAJJAR REVANASIDDAPPACredential: MD

Location Address1718 E 4TH ST STE 907Charlotte, NC 28204-3282

Mailing AddressPo Box 60447Charlotte, NC 28260-0447

Phone(704) 372-4000

Fax(704) 334-4855

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateJuly 14, 2015

Last NPPES UpdateOctober 28, 20253 updates tracked since enumeration

NPPES CertifiedOctober 28, 2025

✔ NPI 1669856217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Licenses✔ Licensed in NC · 2025-01298✔ Licensed in CA · A162179

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1718 E 4TH ST STE 907, Charlotte, NC 28204

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Other Names 1

Other Name (5)Dr. Vanitha Banajjar Md

Secondary Practice Locations 2

Location 1797 W Childs AveMerced, CA 95341-6805 · Phone (866) 682-4842

Location 21650 Grand Concourse, Dept of Ob/GynBronx, NY 10457-7606 · Phone (718) 579-3992

Other Identifiers 1

Medicaid1669856217CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Vanitha Banajjar Revanasiddappa 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 ID941532188

PECOS Enrollment IDI20251008001499

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.

Medicare Billing Reassignments

Medicare enrollment records show Vanitha Banajjar Revanasiddappa reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Novant Health Medical Group, LLC

Same address

Surgery

1718 E 4TH ST STE 307
Charlotte, NC 28204

Reassigned Medicare billing, North Carolina enrollment
Also billed through NPI 1104081959 (North Carolina)
2,998 clinicians in this Medicare group

NPI 1083959282 (704) 333-1259

Golden Valley Health Center

2,191 mi

Federally Qualified Health Center (FQHC)

13161 JEFFERSON ST
Le Grand, CA 95333

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Golden Valley Health Centers
440 clinicians in this Medicare group

NPI 1356325310 (209) 389-1900

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

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

MISS IFEOMA ANULIKA ILO CNW

Advanced Practice Midwife