Individual provider Active NPI

Abelardo Benitez

  • Physician Assistant
  • Twin Falls, ID
National Provider Identifier
1093491706
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9771585 Issued in ID
Practice address
794 Eastland Dr
Twin Falls, ID 83301-6856
Phone
(208) 734-3312
Fax
(208) 734-5036
NPI assigned
Jun 26, 2023
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9771585 ID Primary

Addresses

Primary practice location

794 Eastland Dr
Twin Falls, ID 83301-6856

Mailing address

794 Eastland Dr
Twin Falls, ID 83301-6856
Phone (208) 734-3312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251230001322 ID Practitioner - Physician Assistant 8527554583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

402 6TH St
Rupert, ID 83350-1619
Phone (208) 650-7941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9771585IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Services Corporation Family Medicine Current Accepting new patients
Family Health Services Corporation Family Medicine Current Accepting new patients
Family Health Services Corporation Federally Qualified Health Center (FQHC) CurrentSince Dec 16, 2025 Accepting new patients
Family Health Services Corporation Family Medicine Current Accepting new patients
Family Health Services Corporation Federally Qualified Health Center (FQHC) CurrentSince Dec 16, 2025 Accepting new patients
Family Health Services Corporation Family Medicine Past Accepting new patients

Locations

725 Fair St
Buhl, ID 83316
Phone (208) 543-8271

1309 Bennett Ave
Burley, ID 83318
Phone (208) 677-5198

114 Pioneer Ct
Jerome, ID 83338
Phone (208) 324-3471

218 W Nez Perce
Jerome, ID 83338
Phone (208) 324-3471

402 6th St
Rupert, ID 83350
Phone (208) 650-7941

325 Martin St
Twin Falls, ID 83301
Phone (208) 732-7101

388 Martin St
Twin Falls, ID 83301
Phone (208) 734-0451

794 Eastland Dr
Twin Falls, ID 83301
Phone (208) 734-3312

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1093491706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "ABELARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "9771585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.