Dr Jonathan Christopher Banta, MD is a medicare enrolled "Dermatology" physician in Travis Afb, California. His current practice location is
60 Mdg/sggx, 101 Bodin Cir, Travis Afb, California. You can reach out to his office (for appointments etc.) via phone at
(707) 423-5105.
Dr Jonathan Christopher Banta is licensed to practice in California (license number C203377) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427440791.
Physician's Profile
| Full Name | Dr Jonathan Christopher Banta |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 60 Mdg/sggx, Travis Afb, California |
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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: 1427440791
- Provider Enumeration Date: 02/24/2015
- Last Update Date: 08/14/2025
Medicare PECOS Information:
- PECOS PAC ID: 0648553404
- Enrollment ID: I20170202000519
Medical Identifiers
Medical identifiers for Dr Jonathan Christopher Banta such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1427440791 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207N00000X | Dermatology | C203377 (California) | Primary |
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 Jonathan Christopher Banta 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 Jonathan Christopher Banta, MD 60 Mdg/sggx, 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: () - | Dr Jonathan Christopher Banta, MD 60 Mdg/sggx, 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: (707) 423-5105 |
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