Individual provider Active NPI

Oscar Joseph Benitez, PH.D.

  • Clinical Psychologist
  • Bellevue, WA
National Provider Identifier
1104103423
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60251767 Issued in WA
Practice address
1601 114TH Ave SE Ste 100
Bellevue, WA 98004-6904
Phone
(425) 246-6891
Fax
(425) 533-2515
NPI assigned
Nov 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY60251767 WA Primary

Addresses

Primary practice location

1601 114TH Ave SE Ste 100
Bellevue, WA 98004-6904

Mailing address

1601 114TH Ave SE Ste 100
Bellevue, WA 98004-6904
Phone (425) 246-6891

Other names 1

  • Dr. Oj Benitez Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120104000004 WA Practitioner - Clinical Psychologist 2264608876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11911 NE 1St St
Suite 213
Bellevue, WA 98005-3080
Phone (817) 228-3558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Oscar J. Benitez, PHD Inc Clinical CurrentSince Nov 20, 2011 Accepting new patients

Locations

11911 NE 1st St
Ste 213
Bellevue, WA 98005
Phone (817) 228-3558

1601 114th Ave SE
Ste 100
Bellevue, WA 98004
Phone (206) 618-6653

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1104103423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046904",
            "telephone_number": "425-246-6891",
            "fax_number": "425-533-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 114TH AVE SE STE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046904",
            "telephone_number": "425-246-6891",
            "fax_number": "425-533-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "OSCAR",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60251767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OJ",
            "last_name": "BENITEZ",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.