Kyle J Benner, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD60371397 Issued in WA

Practice address

2671 NE 46TH St
Seattle, WA 98105-5041

Phone

(206) 525-8000

Fax

(206) 525-8070

NPI assigned

May 8, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
• WA PPO C-SNP

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.

• Virginia Mason Medical Center

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1801851258
  Medicare reassignment NPD
• Virginia Mason Medical Center

  • Psychiatry Physician
  • Seattle, WA
  • NPI 1124176904
  NPD
• Virginia Mason Medical Center

  • Family Medicine Physician
  • Bainbridge Island, WA
  • NPI 1730237942
  NPD
• Virginia Mason Medical Center

  • Interventional Cardiology Physician
  • Tacoma, WA
  • NPI 1821711953
  NPD

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1023242708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-515-5811",
            "fax_number": "206-341-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 NE 46TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055041",
            "telephone_number": "206-525-8000",
            "fax_number": "206-525-8070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7320 216th St SW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980268006",
            "country_code": "US",
            "telephone_number": "425-640-4900",
            "fax_number": "425-640-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNER",
        "first_name": "KYLE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60371397",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "60371397",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbenner1041133@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7320 216th St SW Ste 200",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980268006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Genelle Nicole Benker, BA, RYT, RC
• Theresa Benkman, LMT, CTP
• Tanya Benn
• Mica Benner-Kenagy
• Joan Ruez Benner, LICSW
• Courtney Bennett McDuffee
• Molly L. Bennett-Kaufman, ARNP
• Anamika T Bennett, L.D.
• Andrew Bennett
• Angela Michele Bennett, NP-BC

• Psychiatry Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.