NPIMap

Individual provider Active NPI

Matthew Douglas Benson, CRNA

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
National Provider Identifier
1205005204
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0091029 Issued in OK
Practice address
750 NE 13TH St
Suite 200
Oklahoma City, OK 73104-5051
Phone
(405) 271-4351
NPI assigned
Feb 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R032031 SD
Certified Registered Nurse Anesthetist 367500000X 0091029 OK Primary

Addresses

Primary practice location

750 NE 13TH St
Suite 200
Oklahoma City, OK 73104-5051

Mailing address

1122 NE 13TH St
Suite 236
Oklahoma City, OK 73117-1039
Phone (405) 271-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141208000012 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234202730 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Hospital of South Dakota LLCGroup PAC ID 5799777249, 66 clinicians
Ophthalmology LTD Eye Surgery Center L L CGroup PAC ID 1557357175, 9 clinicians
Sioux Falls Specialty Hospital, LLPGroup PAC ID 3173510898, 53 clinicians

Practice addresses (Care Compare)

4500 W 69TH St
Sioux Falls, SD 57108-8148
Phone (605) 977-7000

6601 S Minnesota Ave
Suite 100
Sioux Falls, SD 57108-2564
Phone (605) 336-6294

910 E 20TH St
Sioux Falls, SD 57105-1012
Phone (605) 334-6730

Hospital & facility affiliations

  • Avera Heart Hospital of South Dakota Hospital, Sioux Falls, SD, CCN 430095
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R032031SDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 24, 2014 Accepting new patients
Sioux Falls Specialty Hospital, LLP CurrentSince Jan 15, 2023 Accepting new patients
Ophthalmology LTD Eye Surgery Center L L C CurrentSince May 1, 2022 Accepting new patients
Avera McKennan Nurse Anesthetist, Certified Registered CurrentSince Sep 24, 2014 Accepting new patients
Heart Hospital of South Dakota LLC CurrentSince Oct 31, 2016 Accepting new patients
Sioux Falls Specialty Hospital, LLP CurrentSince Jan 15, 2023 Accepting new patients
Avera McKennan Current Accepting new patients
Heart Hospital of South Dakota LLC CurrentSince Oct 31, 2016 Accepting new patients

Locations

909 N Iowa Ave
Dell Rapids, SD 57022
Phone (605) 428-5431

4500 W 69th St
Sioux Falls, SD 57108
Phone (605) 977-7000

6601 S Minnesota Ave
Ste 100
Sioux Falls, SD 57108
Phone 6053366294630

910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098

Organizations & group practices 8

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 25

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1205005204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "SUITE 236",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 NE 13TH ST",
            "address_2": "SUITE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045051",
            "telephone_number": "405-271-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENSON",
        "first_name": "MATTHEW",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-22",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R032031",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "0091029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; 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.