Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Leou Ismael Banla, MDPHD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1255969267

Dr. Leou Ismael Banla, MDPHD is a Radiation Oncology in Boston, Massachusetts. Graduated from Medical College of Wisconsin in 2020, 6 years ago. Practices with Massachusetts General Physicians Organization Inc, a 3,484-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
6
Trained at
Medical College of Wisconsin
Licensed in
MA
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Boston, MA

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 75 Francis St, Boston, MA 02115-6106 — (617) 732-5500

Specialties & licences

Radiation Oncology Physician (primary) Taxonomy 2085R0001X · Licence 1014502 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1255969267
Entity typeIndividual (Type 1)
GenderMale
Credentials MDPHD
Sole proprietorNo
NPI enumeratedMarch 27, 2020
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyRADIATION ONCOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2020 (6 years in practice)
Group practice Massachusetts General Physicians Organization Inc — 3484 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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