Active NPI
S Charles Bennett IV, AA
- Anesthesiologist Assistant
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 9529
- Practice address
- 12222 Merit Dr Ste 600
Dallas, TX 75251-3294 - Phone
- (972) 715-5000
- Fax
- (972) 715-9976
- NPI assigned
- Mar 24, 2014
- Last updated
- Oct 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | AA000040 | DC | |
| Anesthesiologist Assistant | 367H00000X | 1543 | TX | |
| Anesthesiologist Assistant | 367H00000X | 9529 | GA | Primary |
Addresses
Primary practice location
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Mailing address
PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999
Other practice location 1
110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, GA, TX
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.94 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA000040 | DC | MD | Anesthesiologist Assistant |
| 1543 | TX | MD | Anesthesiologist Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U S Anesthesia Partners of Texas, PA | Current | Accepting new patients | |
| Washington Hospital Center Corp | Current | Accepting new patients | |
| American Anesthesiology Associates of Georgia, LLC | Current | Accepting new patients | |
| U. S. Anesthesia Partners of Texas, P.a., | Anesthesiologist Assistant | Current | Accepting new patients |
| Washington Hospital Center Corp | Current | Accepting new patients | |
| Mak Anesthesia Holdings LLC | Current | Accepting new patients |
Locations
110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000
303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000
247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255
11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452
210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140
5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172
215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207
7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (855) 464-8727
100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555
7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000
9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- Stone Mountain, GA
- NPI 1528068673
-
dba Greater Houston Anesthesiology, P.A.
- Anesthesiology Physician
- Houston, TX
- NPI 1548208564
Anesthesiologist Assistant
-
- Anesthesiology Physician
- Kennesaw, GA
- NPI 1912452939
-
dba Washington Hospital Center Physicians
- Neurological Surgery Physician
- Washington, DC
- NPI 1407870124
-
- Interventional Pain Medicine Physician
- Addison, TX
- NPI 1053800391
-
- General Practice Physician
- Washington, DC
- NPI 1629394424
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Savannah, GA
- NPI 1275527889
-
- General Acute Care Hospital
- Savannah, GA
- NPI 1063406684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729468800000",
"number": "1023435500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840853",
"city": "DALLAS",
"state": "TX",
"postal_code": "752840853",
"telephone_number": "972-233-1999",
"fax_number": "972-233-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12222 MERIT DR STE 600",
"city": "DALLAS",
"state": "TX",
"postal_code": "752513294",
"telephone_number": "972-715-5000",
"fax_number": "972-715-9976"
}
],
"practiceLocations": [
{
"address_1": "110 Irving St NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200103017",
"country_code": "US",
"telephone_number": "202-877-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENNETT",
"first_name": "S CHARLES",
"name_suffix": "IV",
"credential": "AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-24",
"last_updated": "2024-10-21",
"certification_date": "2024-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "DC",
"license": "AA000040",
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "TX",
"license": "1543",
"primary": false
},
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "9529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.