Individual provider Active NPI

Benjamin Coleman Panther, PA-C

  • Physician Assistant
  • Camas, WA
National Provider Identifier
1104227669
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60698188 Issued in WA
Practice address
3240 NE 3Rd Ave
Camas, WA 98607-2408
Phone
(360) 729-8234
Fax
(360) 293-3337
NPI assigned
Sep 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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 PA60698188 WA Primary

Addresses

Primary practice location

3240 NE 3Rd Ave
Camas, WA 98607-2408

Mailing address

3240 NE 3Rd Ave
Camas, WA 98607-2408
Phone (360) 838-2440

Other practice location 1

3240 NE 3rd Ave
Camas, WA 98607-2408
Phone (360) 838-2440

Other practice location 2

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

Other practice location 3

505 NE 87th Ave Ste 260
Vancouver, WA 98664-1965
Phone (360) 514-6450

Other practice location 4

315 NE 192nd Avenue, Suite 310
camas, WA 98607
Phone (360) 729-8200

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031001268 WA Practitioner - Physician Assistant 0648558379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 8820178288, 245 clinicians

Practice addresses (Care Compare)

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

505 NE 87TH Ave
Vancouver, WA 98664-1965

Hospital & facility affiliations

  • Peacehealth Southwest Home Health Home health agency, Vancouver, WA, CCN 507064
  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Jan 4, 2021 Accepting new patients
Southwest Washington Medical Center Past Accepting new patients

Locations

3240 NE 3rd Ave
Camas, WA 98607
Phone (360) 729-8234

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

505 NE 87th Ave
Ste 260
Vancouver, WA 98664
Phone (360) 514-6450

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

16811 SE McGillivray Blvd
Vancouver, WA 98683
Phone (360) 514-4900

Interoperability endpoints

  • Direct secure messaging: bpanther455722@direct.peacehealth.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1104227669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072408",
            "telephone_number": "360-838-2440",
            "fax_number": "360-838-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 NE 3RD AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986072408",
            "telephone_number": "360-729-8234",
            "fax_number": "360-293-3337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3240 NE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Camas",
            "state": "WA",
            "postal_code": "986072408",
            "country_code": "US",
            "telephone_number": "360-838-2440",
            "fax_number": "360-838-2450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16811 SE McGillivray Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986833404",
            "country_code": "US",
            "telephone_number": "360-735-8100",
            "fax_number": "360-253-1781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 NE 87th Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986641965",
            "country_code": "US",
            "telephone_number": "360-514-6450",
            "fax_number": "360-514-6451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 NE 192nd Avenue, Suite 310",
            "address_purpose": "LOCATION",
            "city": "camas",
            "state": "WA",
            "postal_code": "98607",
            "country_code": "US",
            "telephone_number": "360-729-8200",
            "fax_number": "360-729-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTHER",
        "first_name": "BENJAMIN",
        "middle_name": "COLEMAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60698188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

Verify at the official NPI Registry.