Individual provider Active NPI

Mariella Benavides

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1003314956
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
341959 Issued in NY
Practice address
550 1St Ave
New York, NY 10016-6402
Phone
(646) 501-7070
NPI assigned
Jan 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 341959 NY Primary

Addresses

Primary practice location

550 1St Ave
New York, NY 10016-6402

Mailing address

559 Saint Johns PL Apt 3R
Brooklyn, NY 11238-5558
Phone (239) 537-4128

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbenavides114222@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190808001095 NY Practitioner - Nurse Practitioner 9133456577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
341959NYMDNurse Practitioner

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1003314956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 SAINT JOHNS PL APT 3R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385558",
            "telephone_number": "239-537-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "646-501-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDES",
        "first_name": "MARIELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "341959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbenavides114222@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "550 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.