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

Jesse Ryan Banham, PA-C

Individual provider Physician Assistant · NPI 1215867619

Jesse Ryan Banham, PA-C is a Physician Assistant in Ozone Park, New York. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

8304A 101st Ave
Ozone Park, NY 11416-2059
Phone: (718) 772-6012
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1215867619
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 19, 2026
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026
Mailing address8304a 101st Ave, Ozone Park, NY 11416-2059

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