MEDICARE: JAMINELLI L BANKS DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	POD-001064	AZ
2	213ES0000X	Sports Medicine Podiatrist	POD-001064	AZ
3	213E00000X	Podiatrist	POD-001064	AZ
4	213ES0103X	Foot & Ankle Surgery Podiatrist	E5697	CA
5	213ES0131X	Foot Surgery Podiatrist	POD-001064	AZ

General Provider Information

NPI Number	:	1184160517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMINELLI L BANKS DPM

Provider Business Mailing Address
First Line	:	20011 N 19TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85024-1230
Country	:	US
Telephone Number	:	480-471-6132
Fax Number	:	480-393-1979

Provider Business Practice Location Address
First Line	:	3811 E BELL RD STE 207
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2159
Country	:	US
Telephone Number	:	480-863-6044
Fax Number	:	602-926-1299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2017
Last Update Date	:	10/08/2025

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Directions to “ JAMINELLI L BANKS DPM” Practice Location

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