Individual provider Active NPI

Manon K Benisty, PA

  • Physician Assistant
  • Canton, OH
National Provider Identifier
1124624242
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA65977 Issued in CA
Practice address
4535 Dressler Rd NW
Canton, OH 44718-2545
Phone
(330) 493-4443
NPI assigned
Dec 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA65977 CA Primary
Physician Assistant 363A00000X NY

Addresses

Primary practice location

4535 Dressler Rd NW
Canton, OH 44718-2545

Mailing address

358 Hamilton St Apt 2
Albany, NY 12210-1710
Phone (862) 252-5480

Other practice location 1

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-8600

Other practice location 2

1101 Nott St
Schenectady, NY 12308-2489
Phone (518) 243-4000

Other practice location 3

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 525-8600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211122002075 NY Practitioner - Physician Assistant 1052700572 Reassigns benefits to 4 organizations
I20260501000154 CA Practitioner - Physician Assistant 1052700572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Emergency Medical Services PCGroup PAC ID 4981503513, 138 clinicians
Ellis HospitalGroup PAC ID 5890607410, 250 clinicians
Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians

Practice addresses (Care Compare)

103 Sitterly Rd
Halfmoon, NY 12065-5612
Phone (518) 579-2800

1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4121

1740 Rosecrans St
San Diego, CA 92106-1928
Phone (619) 790-7800

Hospital & facility affiliations

  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027578NYMDClinical Psychologist
PA65977CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany Physician Assistant CurrentSince Mar 4, 2024 Accepting new patients
Samaritan Hospital of Troy, New York Physician Assistant CurrentSince Mar 4, 2024 Accepting new patients
St. Peter'S Hospital of the City of Albany Physician Assistant CurrentSince Mar 4, 2024 Accepting new patients
Samaritan Hospital of Troy, New York Physician Assistant CurrentSince Mar 4, 2024 Accepting new patients
Ellis Hospital CurrentSince Mar 18, 2024 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

103 Sitterly Rd
Halfmoon, NY 12065
Phone (518) 579-2700

200 Harborside Dr
Schenectady, NY 12305
Phone (518) 881-4470

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: mbenisty3181327@direct.trinity-health.org

Organizations & group practices 7

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 1

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": "1607212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1124624242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 HAMILTON ST APT 2",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122101710",
            "telephone_number": "862-252-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "330-493-4443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "fax_number": "518-525-6815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 Nott St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123082489",
            "country_code": "US",
            "telephone_number": "518-243-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-525-8600",
            "fax_number": "518-271-3440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENISTY",
        "first_name": "MANON",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-06",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA65977",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.