Individual provider Active NPI

Caitlin Benson, PA

  • Physician Assistant
  • Merced, CA
National Provider Identifier
1194115899
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52268 Issued in CA
Practice address
936 W Main St
Merced, CA 95340-4519
Phone
(209) 383-5200
Fax
(209) 383-5700
NPI assigned
Feb 2, 2015
Last updated
Feb 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 52268 CA Primary

Addresses

Primary practice location

936 W Main St
Merced, CA 95340-4519

Mailing address

1208 Paseo Verde Dr
Merced, CA 95348-1841
Phone (209) 383-5200

Other identifiers 1

IdentifierTypeStateIssuer
52268OtherCAPHYSICIAN ASSISTANT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151204002479 CA Order and Referring Only - Physician Assistant 1557661014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52268CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Centers of the San Joaquin Valley Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: caitlin.benson.1@17661.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1194115899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 PASEO VERDE DR",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953481841",
            "telephone_number": "209-383-5200",
            "fax_number": "209-383-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 W MAIN ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953404519",
            "telephone_number": "209-383-5200",
            "fax_number": "209-383-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "CAITLIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT",
            "identifier": "52268",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.