Individual provider Active NPI

Benjamin Henrie, CRNA

  • Certified Registered Nurse Anesthetist
  • Flagstaff, AZ
National Provider Identifier
1184138679
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
247924 Issued in AZ
Practice address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone
(928) 779-3366
NPI assigned
Nov 20, 2017
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 247924 AZ Primary

Addresses

Primary practice location

1200 N Beaver St
Flagstaff, AZ 86001-3118

Mailing address

167 Main St
Tuba City, AZ 86045
Phone (866) 976-5941

Other practice location 1

716 Stevens Ave
Portland, ME 04103-2656
Phone (207) 283-0171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201019001059 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355672726 Reassigns benefits to 1 organization
I20231011001980 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355672726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesiology Consultants IncGroup PAC ID 4880591841, 284 clinicians

Practice addresses (Care Compare)

167 N Main St
Tuba City Indian Medical Center
Tuba City, AZ 86045-0600
Phone (928) 283-2094

5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (928) 425-3261

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation CurrentSince Aug 22, 2023 Accepting new patients
Tuba City Regional Health Care Corporation Current Accepting new patients
Valley Anesthesiology Consultants, Inc. CurrentSince Jan 6, 2024 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Aug 22, 2023 Accepting new patients

Locations

5880 S Hospital Dr
Globe, AZ 85501
Phone (928) 402-1217

1500 S Dobson Rd
Ste 101
Mesa, AZ 85202
Phone (480) 306-6098

1850 N Central Ave
Ste 1600
Phoenix, AZ 85004
Phone (602) 744-4760

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1184138679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "866-976-5941",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-779-3366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 Stevens Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041032656",
            "country_code": "US",
            "telephone_number": "207-283-0171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRIE",
        "first_name": "BENJAMIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-20",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "247924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.