NPIMap

Organization Active NPI

Luis Benalcazar, MD

  • Internal Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1083801799
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07504600 Issued in NJ
Legal business name
LUIS BENALCAZAR, MD
Practice address
310 Morris Ave
Suite 301
Elizabeth, NJ 07208-3695
Phone
(908) 353-3628
Fax
(908) 353-3625
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Luis Benalcazar, M.D.NPI 1801878269
Title
Medical Director
Phone
(908) 353-3628

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA07504600 NJ Primary

Addresses

Primary practice location

310 Morris Ave
Suite 301
Elizabeth, NJ 07208-3695

Mailing address

310 Morris Ave
Suite 301
Elizabeth, NJ 07208-3695
Phone (908) 353-3628

Other identifiers 2

IdentifierTypeStateIssuer
0028410MedicaidNJ
075232SRAOtherNJCMS RENDERING NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1083801799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MORRIS AVE",
            "address_2": "SUITE 301",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083695",
            "telephone_number": "908-353-3628",
            "fax_number": "908-353-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MORRIS AVE",
            "address_2": "SUITE 301",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083695",
            "telephone_number": "908-353-3628",
            "fax_number": "908-353-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS BENALCAZAR, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "BENALCAZAR",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "908-353-3628",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07504600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028410",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS RENDERING NUMBER",
            "identifier": "075232SRA",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.