Individual provider Active NPI

Elias Ray Benitez Jr., MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1124141924
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD000048532 Issued in WA
Practice address
904 7TH Ave
Seattle, WA 98104-1132
Phone
(206) 320-1670
NPI assigned
Apr 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD000048532 WA Primary

Addresses

Primary practice location

904 7TH Ave
Seattle, WA 98104-1132

Mailing address

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 320-1670

Other practice location 1

3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 339-5470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD000048532WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Internal Medicine Current Accepting new patients
John H. Addison MD PS PastSince Mar 1, 2015 Accepting new patients

Locations

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

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.

NPI Registry JSON

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

{
    "created_epoch": "1175990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1124141924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-320-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-320-1670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3927 Rucker Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982014833",
            "country_code": "US",
            "telephone_number": "425-339-5470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "ELIAS",
        "middle_name": "RAY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-08",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD000048532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.