Blake Ariel Banner, PT
NPI 1942770342ActiveIndividual· Physical Therapist· Forestville, MD
Physical Therapist (PT) with Athletico Ltd, practicing in Forestville, Maryland. Medicare paid $29,339 for services to 34 patients in 2024.
Overview
| NPI | 1942770342 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT |
| Sole proprietor | No |
| NPI issued | Nov 28, 2018 |
| Last updated in NPPES | May 20, 2024 |
| Certified by provider | May 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 05015177A | IN |
| Physical Therapist | 225100000X | 070026352 | IL |
| Physical Therapist | 225100000X | 27579 | MD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (IL); Practitioner - Physical Therapist in Private Practice (IN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 34 |
|---|---|
| Services billed | 1,497 across 10 procedure codes |
| Paid by Medicare | $29,339 |
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Athletico LtdOttawa, IL · 2,200 clinicians
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