NPIMap

Individual provider Active NPI

Theresa Renee Benecki, M.D.

  • Gynecology Physician
  • Brick, NJ
National Provider Identifier
1003895418
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MA03689200 Issued in NJ
Practice address
1608 Highway 88
Suite 208
Brick, NJ 08724-3009
Phone
(732) 458-7878
Fax
(732) 840-6378
NPI assigned
Jan 13, 2006
Last updated
Oct 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 25MA03689200 NJ Primary

Addresses

Primary practice location

1608 Highway 88
Suite 208
Brick, NJ 08724-3009

Mailing address

1608 Highway 88
Suite 208
Brick, NJ 08724-3009
Phone (732) 458-7878

Other identifiers 1

IdentifierTypeStateIssuer
2533006MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110621000651 NJ Practitioner - Obstetrics/Gynecology 1658559620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Jefferson Medical College of Thomas Jefferson University, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1608 Hwy 88
Suite 208
Brick, NJ 08724-3009
Phone (732) 458-7878

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.02 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
76.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Pineland Associates in Obstetrics-Gynecology,PA Gynecology CurrentSince Feb 13, 1990 Accepting new patients

Locations

1608 Highway 88
Ste 208
Brick, NJ 08724
Phone (732) 458-7878

Interoperability endpoints

  • Direct secure messaging: theresabenecki@mai.allscriptsdirect.net
  • Direct secure messaging: theresabenecki@pinelandas.allscriptsdirect.net

Organizations & group practices 2

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1003895418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 HIGHWAY 88",
            "address_2": "SUITE 208",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243009",
            "telephone_number": "732-458-7878",
            "fax_number": "732-840-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 HIGHWAY 88",
            "address_2": "SUITE 208",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243009",
            "telephone_number": "732-458-7878",
            "fax_number": "732-840-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENECKI",
        "first_name": "THERESA",
        "middle_name": "RENEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MA03689200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2533006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.