Individual provider Active NPI

Ivan R Bennett, PA

  • Physician Assistant
  • West Chester, OH
National Provider Identifier
1184658056
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50002463 Issued in OH
Practice address
7798 Discovery Dr.
West Chester, OH 45069-6542
Phone
(513) 939-2263
Fax
(513) 874-4579
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50-002463 OH
Physician Assistant 363A00000X 50002463 OH Primary

Addresses

Primary practice location

7798 Discovery Dr.
West Chester, OH 45069-6542

Mailing address

PO Box 636256 Central Credentialing
Cincinnati, OH 45263-6256
Phone (513) 585-5506

Other identifiers 2

IdentifierTypeStateIssuer
7100001230MedicaidKY
BEPA27101OtherOHMEDICARE CGS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060816000316 OH Practitioner - Physician Assistant 4082617840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

7690 Discovery Dr
West Chester, OH 45069-6542
Phone (513) 475-7425

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50002463OHMDPhysician Assistant
50-002463OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Physician Assistant CurrentSince Jan 5, 2015 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Emergency Medicine Physicians of Hamilton County, LTD. Past Accepting new patients

Locations

70 Damon Rd
Cincinnati, OH 45218
Phone (513) 605-1000

222 Piedmont Ave
Ste 7000
Cincinnati, OH 45219
Phone (513) 475-8772

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

222 Piedmont Ave
Ste 5400
Cincinnati, OH 45219
Phone (513) 475-8881

9275 Montgomery Rd
Ste 200
Montgomery, OH 45242
Phone (513) 936-4510

7750 Discovery Dr
West Chester, OH 45069
Phone (513) 298-7325

7798 Discovery Dr
West Chester, OH 45069
Phone (513) 424-7711

7700 University Dr
West Chester, OH 45069
Phone (513) 298-3000

7690 Discovery Dr
West Chester, OH 45069
Phone (513) 475-7425

Interoperability endpoints

  • Direct secure messaging: ibennett29543@direct.uchealth.com

Organizations & group practices 3

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 2

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1184658056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636256 CENTRAL CREDENTIALING",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636256",
            "telephone_number": "513-585-5506",
            "fax_number": "513-585-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7798 DISCOVERY DR.",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450696542",
            "telephone_number": "513-939-2263",
            "fax_number": "513-874-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "IVAN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50-002463",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50002463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100001230",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CGS",
            "identifier": "BEPA27101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.