Active NPI
Douglas P Benoit, O.D.
- Corneal and Contact Management Optometrist
- Concord, NH
National Provider Identifier
1083608491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 0434
- Practice address
- 2 Pillsbury St Ste 100
Concord, NH 03301-3502 - Phone
- (603) 228-1104
- Fax
- (603) 228-7061
- NPI assigned
- Aug 31, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0434 | NH | |
| Corneal and Contact Management Optometrist | 152WC0802X | 0434 | NH | Primary |
Addresses
Primary practice location
2 Pillsbury St Ste 100
Concord, NH 03301-3502
Mailing address
2 Pillsbury St Ste 100
Concord, NH 03301-3502
Phone (603) 228-1104
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0214001001 | Other | NH | CIGNA |
| 0905184Y0NH01 | Other | NH | ANTHEM NH |
| 99002291 | Medicaid | NH | |
| 180027368 | Other | NH | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1051 | NM | MD | Acupuncturist |
| 0434 | NH | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1083608491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 PILLSBURY ST STE 100",
"city": "CONCORD",
"state": "NH",
"postal_code": "033013502",
"telephone_number": "603-228-1104",
"fax_number": "603-228-7061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 PILLSBURY ST STE 100",
"city": "CONCORD",
"state": "NH",
"postal_code": "033013502",
"telephone_number": "603-228-1104",
"fax_number": "603-228-7061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENOIT",
"first_name": "DOUGLAS",
"middle_name": "P",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-31",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NH",
"license": "0434",
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "NH",
"license": "0434",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0214001001",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM NH",
"identifier": "0905184Y0NH01",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "99002291",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180027368",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.