Individual provider Active NPI

Benadette N Ngamelue, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1154948735
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71310 Issued in AZ
Practice address
2927 N 7TH Ave
Phoenix, AZ 85013-4102
Phone
(602) 406-3153
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TEP8920 NE
Family Medicine Physician 207Q00000X 71310 AZ Primary

Addresses

Primary practice location

2927 N 7TH Ave
Phoenix, AZ 85013-4102

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other identifiers 1

IdentifierTypeStateIssuer
470553011-00MedicaidNE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address benadette.ngamelue.1@9271.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240412002654 AZ Practitioner - Family Practice 5294154431 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

2927 N 7TH Ave
DHMG St. Joseph'S Family Medicine
Phoenix, AZ 85013-4102
Phone (602) 406-3153

Hospital & facility affiliations

  • St Josephs Hospital and Medical Center Hospital, Phoenix, AZ, CCN 030024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71310AZMDFamily Medicine Physician
TEP8920NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Association, Inc. CurrentSince Nov 19, 2024 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Sjhmc Physician Services CurrentSince Mar 1, 2025 Accepting new patients
Community Hospital Association, Inc. CurrentSince Nov 19, 2024 Accepting new patients

Locations

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

2927 N 7th Ave
Phoenix, AZ 85013
Phone (602) 406-3153

520 Rose Ln
Wickenburg, AZ 85390
Phone (928) 666-1197

523 Rose Ln
Wickenburg, AZ 85390
Phone (928) 668-1833

32919 N Center St
Wittmann, AZ 85361
Phone (928) 668-1833

File 56765
Los Angeles, CA 90074

Interoperability endpoints

  • Direct secure messaging: benadette.ngamelue.1@24378.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1154948735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 N 7TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134102",
            "telephone_number": "602-406-3153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGAMELUE",
        "first_name": "BENADETTE",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "TEP8920",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "71310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470553011-00",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benadette.ngamelue.1@9271.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "4600 Valley Rd Ste 200",
            "city": "Lincoln",
            "state": "NE",
            "country_code": "US",
            "postal_code": "685104882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.