Individual provider Active NPI

Matthew James Benage, MD

  • Ophthalmology Physician
  • Vancouver, WA
National Provider Identifier
1013364165
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD61034769 Issued in WA
Practice address
2525 NE 139TH St Ste 280
Vancouver, WA 98686-2719
Phone
(360) 882-2778
Fax
(360) 604-1780
NPI assigned
May 18, 2016
Last updated
Oct 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD61034769 WA Primary

Addresses

Primary practice location

2525 NE 139TH St Ste 280
Vancouver, WA 98686-2719

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (417) 531-2229

Other identifiers 1

IdentifierTypeStateIssuer
2159830MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200623001452 WA Practitioner - Ophthalmology 4486947140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Missouri, Columbia School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

4500 SE Columbia Palisades Dr
Camas, WA 98607-8444
Phone (360) 882-2778

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61034769WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jul 27, 2020 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jul 27, 2020 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

4500 SE Columbia Palisades Dr
Camas, WA 98607

2525 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1500

2525 NE 139th St
Ste 280
Vancouver, WA 98686

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Interoperability endpoints

  • Direct secure messaging: mbenage16552@tvc-direct.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1013364165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NE 139TH ST STE 280",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862719",
            "telephone_number": "360-882-2778",
            "fax_number": "360-604-1780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "417-531-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENAGE",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD61034769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2159830",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.