NPIMap

Individual provider Active NPI

Prasert Vijitbenjaronk, M.D.

  • Interventional Cardiology Physician
  • Lafayette, IN
National Provider Identifier
1124002951
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
01090864A Issued in IN
Practice address
3900 St Francis Way Ste 200
Lafayette, IN 47905-4940
Phone
(765) 775-2800
Fax
(765) 775-2831
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2004009714 MO
Cardiovascular Disease Physician 207RC0000X 2004009714 MO
Cardiovascular Disease Physician 207RC0000X 01090864A IN
Interventional Cardiology Physician 207RI0011X 01090864A IN Primary

Addresses

Primary practice location

3900 St Francis Way Ste 200
Lafayette, IN 47905-4940

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

1150 State Highway 248
Ste. 200
Branson, MO 65616-3758
Phone (417) 336-4112

Other identifiers 9

IdentifierTypeStateIssuer
653949OtherMOHEALTHLINK
155765001MedicaidAR
126814OtherBCBS
P00244271OtherRAILROAD MEDICARE
207663907MedicaidMO
250766OtherHEALTHLINK
190900OtherMOBLUE CROSS BLUE CHOICE
155783001MedicaidAR
190900OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031002643 IN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5799687786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

3900 St Francis Way
Suite 200
Lafayette, IN 47905-4923
Phone (765) 463-2399

Hospital & facility affiliations

  • Franciscan Health Lafayette Hospital, Lafayette, IN, CCN 150109
  • Franciscan Health Crawfordsville Hospital, Crawfordsville, IN, CCN 150022
  • Franciscan Health Rensselaer, Inc Hospital, Rensselaer, IN, CCN 151324
  • Franciscan Health Indianapolis Hospital, Indianapolis, IN, CCN 150162
  • Indiana University Health Arnett Hospital Hospital, Lafayette, IN, CCN 150173

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting30
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01090864AINMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Oct 8, 2023 Accepting new patients
Franciscan Physician Network CurrentSince Oct 8, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Pacific County Hospital District 2 PastSince Aug 1, 2012 Accepting new patients
Skaggs Community Health Center and Clinics Specialist Past Accepting new patients
Richard D. Tallon, DDS, PC Past Accepting new patients
Heart Health PA Cardiovascular Disease Past Accepting new patients
Pacific County Hospital District 2 Past Accepting new patients
Shawnee Mission Medical Center Inc Past Accepting new patients

Locations

1710 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 362-2800

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

3900 St Francis Way
Ste 200
Lafayette, IN 47905
Phone (765) 775-2800

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: prasert.vijitbenjaronk@cernerdirect.coxhealth.com

Organizations & group practices 9

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 7

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1124002951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 ST FRANCIS WAY STE 200",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054940",
            "telephone_number": "765-775-2800",
            "fax_number": "765-775-2831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 State Highway 248",
            "address_2": "Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656163758",
            "country_code": "US",
            "telephone_number": "417-336-4112",
            "fax_number": "417-335-7588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIJITBENJARONK",
        "first_name": "PRASERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2004009714",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2004009714",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01090864A",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IN",
            "license": "01090864A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "653949",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155765001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "126814",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00244271",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207663907",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "250766",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE CHOICE",
            "identifier": "190900",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155783001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "190900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.