Individual provider Active NPI

Michael Gerard Bennese, D.C.

  • Chiropractor
  • Enola, PA
National Provider Identifier
1093770695
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008015L Issued in PA
Practice address
30 East Shady Lane
Enola, PA 17025
Phone
(717) 732-2222
Fax
(717) 732-9811
NPI assigned
Apr 18, 2006
Last updated
Oct 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC008015L PA Primary

Addresses

Primary practice location

30 East Shady Lane
Enola, PA 17025

Mailing address

30 East Shady Lane
Enola, PA 17025
Phone (717) 732-2222

Other identifiers 3

IdentifierTypeStateIssuer
1035099OtherPAASHN
001314434OtherPAHIGHMARK B. S.
02978500OtherPACAPITAL BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000152 PA Practitioner - Chiropractic 2062415482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bennese Family Chiropractic PCGroup PAC ID 6305841669, 2 clinicians

Practice addresses (Care Compare)

30 E Shady LN
Suite B
Enola, PA 17025-2354
Phone (717) 732-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bennese Family Chiropractic PC Chiropractor CurrentSince Jan 1, 2006 Accepting new patients

Locations

30 E Shady Ln
Enola, PA 17025
Phone (717) 732-4911

30 E Shady Ln
Ste B
Enola, PA 17025
Phone (717) 732-2222

433 N Enola Rd
Enola, PA 17025
Phone (717) 732-2222

Organizations & group practices 1

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1093770695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 EAST SHADY LANE",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "17025",
            "telephone_number": "717-732-2222",
            "fax_number": "717-732-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 EAST SHADY LANE",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "17025",
            "telephone_number": "717-732-2222",
            "fax_number": "717-732-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNESE",
        "first_name": "MICHAEL",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008015L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHN",
            "identifier": "1035099",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK B. S.",
            "identifier": "001314434",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02978500",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enola, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.