Individual provider Active NPI

Patricia C. Benjamin, O.D.

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1073588869
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
R-102-TA-098 Issued in AL
Practice address
2019 Highland Ave S
Birmingham, AL 35205-3801
Phone
(205) 328-2020
Fax
(205) 918-9096
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X R-102-TA-098 AL Primary

Addresses

Primary practice location

2019 Highland Ave S
Birmingham, AL 35205-3801

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other identifiers 2

IdentifierTypeStateIssuer
000058546MedicaidAL
R102-TA-098OtherALAL BOARD OF OPTOMETRY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000427 AL Practitioner - Optometry 3072568898 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Alabama, LLC Optometrist CurrentSince Nov 20, 2017 Accepting new patients
Myeyedr Optometry of Alabama LLC Optometrist CurrentSince Nov 20, 2017 Accepting new patients
Myeyedr Optometry of Alabama LLC Optometrist Current Accepting new patients
Schaeffer Eye Center Inc Past Accepting new patients

Locations

2019 Highland Ave S
Birmingham, AL 35205
Phone (205) 328-2020

3431 Colonnade Pkwy
Ste 100
Birmingham, AL 35243
Phone (205) 967-2020

195 Highway 304
Calera, AL 35040
Phone (205) 668-7920

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: pbenjamin007373@myeyedr.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1073588869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 HIGHLAND AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352053801",
            "telephone_number": "205-328-2020",
            "fax_number": "205-918-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "PATRICIA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R-102-TA-098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058546",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL BOARD OF OPTOMETRY",
            "identifier": "R102-TA-098",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.