NPIMap

Individual provider Active NPI

Travis James Bench, MD

  • Cardiovascular Disease Physician
  • Stony Brook, NY
National Provider Identifier
1033142526
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
245267 Issued in NY
Practice address
HSC T16 080
Stony Brook, NY 11794-8167
Phone
(631) 444-1060
Fax
(631) 444-1054
NPI assigned
Jul 8, 2006
Last updated
Sep 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006594 NY
Student in an Organized Health Care Education/Training Program 390200000X 245267 NY
Internal Medicine Physician 207R00000X 00245267 NY
Internal Medicine Physician 207R00000X 245267 NY
Cardiovascular Disease Physician 207RC0000X 245267 NY Primary

Addresses

Primary practice location

HSC T16 080
Stony Brook, NY 11794-8167

Mailing address

PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-0650

Other identifiers 2

IdentifierTypeStateIssuer
03424935MedicaidNY
245267OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120209000358 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 1658385398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
State University of New York at Stony Brook, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

676 County Rd
39A
Southampton, NY 11968-5241
Phone (631) 283-2070

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00245267NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Surgical Associates, University Faculty Practice Corporati Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Cardiovascular Disease CurrentSince Oct 3, 2016 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

676 County Road 39A
Southampton, NY 11968
Phone (631) 283-2070

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: travis.bench@direct.stonybrookmedicine.edu

Organizations & group practices 4

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 6

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1033142526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-0650",
            "fax_number": "631-638-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC T16 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948167",
            "telephone_number": "631-444-1060",
            "fax_number": "631-444-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENCH",
        "first_name": "TRAVIS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006594",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "245267",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "00245267",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "245267",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "245267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03424935",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "245267",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.