Individual provider Active NPI

Mary Ellen Benzik, MD

  • Family Medicine Physician
  • Battle Creek, MI
National Provider Identifier
1104888791
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301058049 Issued in MI
Practice address
181 W Emmett St
Battle Creek, MI 49037-2963
Phone
(269) 966-2600
Fax
(269) 965-4773
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301058049 MI Primary

Addresses

Primary practice location

181 W Emmett St
Battle Creek, MI 49037-2963

Mailing address

181 W Emmett St
Battle Creek, MI 49037-2963
Phone (269) 966-2600

Other identifiers 1

IdentifierTypeStateIssuer
4939460MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301058049MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayone City Care Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-dayone

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1104888791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 W EMMETT ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372963",
            "telephone_number": "269-966-2600",
            "fax_number": "269-965-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W EMMETT ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372963",
            "telephone_number": "269-966-2600",
            "fax_number": "269-965-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENZIK",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4939460",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.