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MR. KENNETH JOHN BANNON BSPA-C
NPI 1821055047
Physician Assistant in Carbondale, PA

Active since May 01, 2006PECOS EnrolledAccepts Medicare Assignment
111 SALEM AVENUE, SUITE 302, CARBONDALE, PA 18407(570) 282-2031(570) 282-2534 Get Directions Write a Review

NPPES record last updated: March 23, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Kenneth John Bannon Bspa-c NPPES

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

MR. KENNETH JOHN BANNON BSPA-C (NPI 1821055047) is an individual physician assistant in Carbondale, Pennsylvania, licensed in Pennsylvania (MA001023L) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1986).

NPPES Registry Identity

NPI1821055047
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. KENNETH JOHN BANNONCredential: BSPA-C
Location Address111 SALEM AVENUE, SUITE 302Carbondale, PA 18407-2574
Mailing Address601 Park StHonesdale, PA 18431-1445
Phone(570) 282-2031
Fax(570) 282-2534
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateMay 1, 2006
Last NPPES UpdateMarch 23, 2015
✔ NPI 1821055047 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in PA · MA001023L
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
111 SALEM AVENUE, Carbondale, PA 18407
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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

Mr. Kenneth John Bannon Bspa-c 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 ID4587624275
PECOS Enrollment IDI20230112001334
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 5

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 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.
661 services450 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.
213 services160 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.
197 services197 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.
84 services84 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
43 services43 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18407 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

Referred Medical Equipment & Supplies CMS DME claims 7

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers81 claims160 services$4.87 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers30 claims41 services$1.02 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier16 claims16 services$7.02 avg. paid by Medicare
Neuromuscular stimulator, electronic shock unit E0745
DME-Other DME · category DE000N
1 supplier14 claims14 services$51.16 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
4 suppliers14 claims2,073 services$0.03 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$203.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Kenneth Bannon's NPI number?

The NPI number for Kenneth Bannon is 1821055047. It was assigned to this individual provider in the NPPES registry on May 1, 2006.

Where is Kenneth Bannon located?

Kenneth Bannon practices at 111 Salem Avenue Suite 302, Carbondale, PA 18407. The listed phone number is (570) 282-2031.

What is Kenneth Bannon's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kenneth Bannon enrolled in Medicare?

Yes. Kenneth Bannon 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.

When was this NPI record last updated?

The NPPES record for Kenneth Bannon was last updated on March 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.