Active NPI
Martin Bennett, M.D.
- Family Medicine Physician
- Sherman Oaks, CA
National Provider Identifier
1164598140
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Sep 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A31783
- Practice address
- 15450 Ventura Blvd Ste 102
Sherman Oaks, CA 91403-3061 - Phone
- (818) 784-1035
- Fax
- (818) 784-5804
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A31783 | CA | Primary |
Addresses
Primary practice location
15450 Ventura Blvd Ste 102
Sherman Oaks, CA 91403-3061
Mailing address
15450 Ventura Blvd Ste 102
Sherman Oaks, CA 91403-3061
Phone (818) 784-1035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A31783 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1164598140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15450 VENTURA BLVD STE 102",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914033061",
"telephone_number": "818-784-1035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15450 VENTURA BLVD STE 102",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914033061",
"telephone_number": "818-784-1035",
"fax_number": "818-784-5804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "MARTIN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A31783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.