Tom D Bennetch, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4446 Issued in AZ

Practice address

297 S Lake Havasu Ave
#102
Lake Havasu City, AZ 86403

Phone

(928) 453-0501

Fax

(928) 453-0502

NPI assigned

Aug 20, 2006

Last updated

Aug 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

True Rehab of Arizona,LLCGroup PAC ID 3870546393, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.87 of 100Reported as group

Quality

100

Improvement activities

40

Cost

79.56

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• True Rehab of Arizona,LLC

  • Physical Therapy Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1801941992
  Medicare reassignment Care Compare group NPD Authorized official
• Innovative Health Care of Havasu LLC

  • Family Health Clinical Nurse Specialist
  • Lake Havasu City, AZ
  • NPI 1114230893
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1174638084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 MCCULLOCH BLVD N",
            "address_2": "#D282",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035749",
            "telephone_number": "928-453-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 S LAKE HAVASU AVE",
            "address_2": "#102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "86403",
            "telephone_number": "928-453-0501",
            "fax_number": "928-453-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETCH",
        "first_name": "TOM",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "4446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Diane Beckstrom, PTA
• Morgan Taylor Beckwith, PA
• Anju Beesetty, M.D.
• Shelley Ann Bengard, D.C.
• Stacey Diane Benjamin
• Danielle Bennett, LMT
• Gail Marie Benson, RN
• Heidi A Berdin, MD
• Faith Tara Berstler, RN
• Steven Bertovich, R.N.

• Physical Therapist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.