Active NPI
Thomas Edward Beniak, PHD
- Clinical Neuropsychologist
- Minneapolis, MN
National Provider Identifier
1043227515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- LP0706
- Practice address
- 5775 Wayzata Blvd Ste 200
Minneapolis, MN 55416-1227 - Phone
- (952) 525-4511
- Fax
- (952) 525-1560
- NPI assigned
- Aug 1, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | LP0706 | MN | Primary |
Addresses
Primary practice location
5775 Wayzata Blvd Ste 200
Minneapolis, MN 55416-1227
Mailing address
5775 Wayzata Blvd Ste 200
Minneapolis, MN 55416-1227
Phone (952) 525-4511
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP37238 | Other | HEALTHPARTNERS | |
| 765445 | Other | AMERICAS PPO | |
| 15-82098 | Other | MEDICA | |
| 01014969 | Other | PREFERRED ONE | |
| 10088 | Medicaid | ND | |
| 71318BE | Other | BLUE CROSS BLUE SHIELD | |
| A015 | Other | TRIWEST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043227515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5775 WAYZATA BLVD STE 200",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554161227",
"telephone_number": "952-525-4511",
"fax_number": "952-525-1560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5775 WAYZATA BLVD STE 200",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554161227",
"telephone_number": "952-525-4511",
"fax_number": "952-525-1560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENIAK",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MN",
"license": "LP0706",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP37238",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "765445",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "15-82098",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "01014969",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10088",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "71318BE",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST",
"identifier": "A015",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.