Organization Active NPI

Benjamin Medical PLLC

  • Internal Medicine Physician
  • Olympia, WA
National Provider Identifier
1124357652
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BENJAMIN MEDICAL PLLC
Practice address
1340 Allegheny CT SE
Olympia, WA 98503-1905
Phone
(360) 742-4617
NPI assigned
Dec 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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

Authorized official

Name
Dr. Sabrina Ann Benjamin, M.D.NPI 1447280334
Title
Owner
Phone
(360) 742-4617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1340 Allegheny CT SE
Olympia, WA 98503-1905

Mailing address

1340 Allegheny CT SE
Olympia, WA 98503-1905
Phone (360) 742-4617

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100210000638 WA Part B Supplier - Clinic/Group Practice 0941343131 Receives reassigned benefits from 1 practitioner
Practice locations: Tacoma, WA; University Place, WA; Shelton, WA; Lacey, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260489600000",
    "number": "1124357652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 ALLEGHENY CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985031905",
            "telephone_number": "360-742-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 ALLEGHENY CT SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985031905",
            "telephone_number": "360-742-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2009-12-11",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-742-4617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.