Individual provider Active NPI

Marco A Benitez, M.D

  • Neurology Physician
  • Lufkin, TX
National Provider Identifier
1013022979
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
L8616 Issued in TX
Practice address
3006 S 1St St Ste B
Lufkin, TX 75901-7112
Phone
(936) 639-2222
Fax
(936) 639-8810
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME145526 FL
Neurology Physician 2084N0400X L8616 TX Primary

Addresses

Primary practice location

3006 S 1St St Ste B
Lufkin, TX 75901-7112

Mailing address

3006 S 1St St Ste B
Lufkin, TX 75901-7112
Phone (936) 639-2222

Other practice location 1

2130 SW 24th Ter
Miami, FL 33145-3733
Phone (936) 676-3516

Other identifiers 1

IdentifierTypeStateIssuer
177021601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050921000955 TX Practitioner - Neurology 3678470036 Reassigns benefits to 1 organization
I20210702002563 FL Practitioner - Neurology 3678470036

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3006 S 1St St
Suite B
Lufkin, TX 75901-7112
Phone (936) 639-2222

Hospital & facility affiliations

  • Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME145526FLMDNeurology Physician
L8616TXMDNeurology Physician

Interoperability endpoints

  • Direct secure messaging: mbenitez271142@mhsdirect.net

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.

Hospital & facility affiliations 1

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1013022979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3006 S 1ST ST STE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759017112",
            "telephone_number": "936-639-2222",
            "fax_number": "936-639-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 S 1ST ST STE B",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759017112",
            "telephone_number": "936-639-2222",
            "fax_number": "936-639-8810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 SW 24th Ter",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331453733",
            "country_code": "US",
            "telephone_number": "936-676-3516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "MARCO",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME145526",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "L8616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177021601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.