Barry Joseph Benzing, PA-C
Individual provider Active NPI Physician Assistant · Montclair, NJ
NPI 1063969467 · NPPES record last updated Nov 18, 2016
Key facts
- NPI
- 1063969467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00417400 (NJ)
- Practice address
- 1 Bay Ave
Montclair, NJ 07042-4837 - Phone
- (973) 429-6000
- NPI assigned
- Sep 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170127002341 | NJ | Practitioner - Physician Assistant | 7416239330 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00417400 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nes Georgia Inc | Current |
Accepting new patients | |
| Hudson Hospital Opco LLC | Current | Accepting new patients | |
| Ambulatory Pain and Disability Management Center LLC | Current | Accepting new patients | |
| The Radiology Group of New Jersey, LLC | Past | Accepting new patients | |
| Inspira Health Network Medical Group, P.C. | Past | Accepting new patients |
Locations
225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204
191 Palisade Ave
Jersey City, NJ 07306
Phone (201) 656-4324
111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060
Interoperability endpoints
- barry.benzing@direct.christhospital.md
- hackensackmeridian.barrybenzing@136290.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00417400 | NJ | Yes |
Addresses
Primary practice location
1 Bay Ave
Montclair, NJ 07042-4837
Mailing address
66 W Gilbert St Ste 100
Tinton Falls, NJ 07701-4948
Phone (732) 212-0060
Other providers in Montclair, NJ
- Tara J Benigno
- Amanda Benjamin
- Ahshayla Bennett
- Nicole Bennett
- Billy Benson
- Mara Michelle Berganovsky
- Yelena Berlin
- Jacqueline Berliner
- Jessica Berliner
- Francis Berlingeri
All providers in Montclair, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.