Michael Richard Benoit, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

CDRH.0053386 Issued in CO

Practice address

1120 W South Boulder Rd Ste 102I
Lafayette, CO 80026-8952

Phone

(720) 743-5672

Fax

(720) 812-9193

NPI assigned

Jun 21, 2011

Reactivated

Jul 11, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1043506785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W SOUTH BOULDER RD STE 102I",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268952",
            "telephone_number": "720-743-5672",
            "fax_number": "720-812-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 W SOUTH BOULDER RD STE 102I",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800268952",
            "telephone_number": "720-743-5672",
            "fax_number": "720-812-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENOIT",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "deactivation_date": "2023-06-27",
        "reactivation_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "53386",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "CDRH.0053386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Bender, LCSW
• Emily Christine Benham, MD
• Benjamin White Psychotherapy, PLLC
• Emily Bennett, ACSW
• Cecilia Benns, FNP-C
• Jammie Ann Benton-Speyer
• Dorothy Megan Berens, RD
• Judith Berg, NP
• Dianne J Berger, NP
• Scott M Berger, M.D.

• Internal Medicine Physician in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.