NPIMap

Individual provider Active NPI

Derek B Benz, PA-C

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1033703624
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2021006539 Issued in MO
Practice address
2725 S Crutcher Ave
Springfield, MO 65804-3837
Phone
(000) 000-0000
NPI assigned
Feb 24, 2021
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2021006539 MO Primary

Addresses

Primary practice location

2725 S Crutcher Ave
Springfield, MO 65804-3837

Mailing address

2725 S Crutcher Ave
Springfield, MO 65804-3837

Other identifiers 1

IdentifierTypeStateIssuer
2021006539OtherMOSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210310001548 MO Practitioner - Physician Assistant 8022424456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

3050 E River Bluff Blvd
MC Orthopedics
Ozark, MO 65721-8807
Phone (417) 820-5610

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Aug 26, 2024 Accepting new patients
Mercy Clinic Springfield Communities Physician Assistant CurrentSince Aug 26, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Aug 26, 2024 Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

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 12

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": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1033703624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S CRUTCHER AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S CRUTCHER AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043837",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENZ",
        "first_name": "DEREK",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021006539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2021006539",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.