Dr Jim Jaralene Porquez Banno, MD is a medicare enrolled "Family Medicine" physician in Kenansville, North Carolina. Her current practice location is
748 Kenansville Byp, Kenansville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(910) 296-8080.
Dr Jim Jaralene Porquez Banno is licensed to practice in North Carolina (license number 2024-00756) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1205417722.
Physician's Profile
Full Name | Dr Jim Jaralene Porquez Banno |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 748 Kenansville Byp, Kenansville, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205417722
- Provider Enumeration Date: 04/16/2021
- Last Update Date: 03/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 8022418599
- Enrollment ID: I20240612001101
Medical Identifiers
Medical identifiers for Dr Jim Jaralene Porquez Banno such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205417722 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 2024-00756 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jim Jaralene Porquez Banno allows following entities to bill medicare on her behalf.
Entity Name | Goshen Medical Center Incorporated |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1023424686 PECOS PAC ID: 3173434479 Enrollment ID: O20040102000726 |
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Entity Name | Vidant Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jim Jaralene Porquez Banno is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jim Jaralene Porquez Banno, MD 2100 Stantonsburg Rd, Greenville, NC 27834-2818 Ph: () - | Dr Jim Jaralene Porquez Banno, MD 748 Kenansville Byp, Kenansville, NC 28349-9064 Ph: (910) 296-8080 |
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