Individual provider Active NPI

William L Benedict, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Longmont, CO
National Provider Identifier
1063598548
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
32437 Issued in CO
Practice address
1400 Dry Creek Dr
Longmont, CO 80503-6505
Phone
(303) 772-3300
Fax
(303) 682-3380
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 32437 CO
Retina Specialist (Ophthalmology) Physician 207WX0107X 32437 CO Primary

Addresses

Primary practice location

1400 Dry Creek Dr
Longmont, CO 80503-6505

Mailing address

1400 Dry Creek Dr
Longmont, CO 80503-6499
Phone (303) 772-3300

Other identifiers 1

IdentifierTypeStateIssuer
01324375MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041217000809 CO Practitioner - Ophthalmology 4688631963 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Center of Northern Colorado, PC Ophthalmology CurrentSince Sep 9, 1996 Accepting new patients

Locations

1400 Dry Creek Dr
Longmont, CO 80503
Phone (303) 682-3383

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1063598548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DRY CREEK DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036499",
            "telephone_number": "303-772-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DRY CREEK DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036505",
            "telephone_number": "303-772-3300",
            "fax_number": "303-682-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "32437",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CO",
            "license": "32437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01324375",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.