Peter Ward Benoit
Individual provider Active NPI Case Manager/Care Coordinator · Wasilla, AK
NPI 1083237705 · NPPES record last updated May 28, 2020
Key facts
- NPI
- 1083237705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1363 W Spruce Ave
Wasilla, AK 99654-5327 - Phone
- (907) 376-2411
- NPI assigned
- May 28, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mat - Su Health Services Inc. | Current |
Accepting new patients |
Locations
1363 W Spruce Ave
Wasilla, AK 99654
Phone (907) 376-2411
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1363 W Spruce Ave
Wasilla, AK 99654-5327
Mailing address
1363 W Spruce Ave
Wasilla, AK 99654-5327
Phone (907) 376-2411
Other providers in Wasilla, AK
- Alicia J Bendistis
- Aaron Benjamin
- Anna Eleanor Bennett
- Stephanie Bennett
- Kathleen Benoit
- Anne Benson
- Laurie Benson
- Paul W Bentley
- Deterrieo Benton
- Madison Virgina Berard
All providers in Wasilla, AK · Case Manager/Care Coordinator in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.