NPIMap

Individual provider Active NPI

Erik Michael Benjamin, PA-C

  • Physician Assistant
  • Williamsport, PA
National Provider Identifier
1205568193
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA006117 Issued in PA
Practice address
1705 Warren Ave Ste 101-103
Williamsport, PA 17701-2647
Phone
(570) 321-2020
NPI assigned
Jun 29, 2022
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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 OA006117 PA Primary

Addresses

Primary practice location

1705 Warren Ave Ste 101-103
Williamsport, PA 17701-2647

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (888) 647-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816000800 PA Practitioner - Physician Assistant 5597148049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

1201 Grampian Blvd
Williamsport, PA 17701-1965

1705 Warren
205 Suite U4 Susquehanna Health ENT
Williamsport, PA 17701-2647
Phone (570) 320-7474

1705 Warren Ave
Williamsport, PA 17701-2647
Phone (570) 321-2020

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2330 Saint Mary St W
Lewisburg, PA 17837-8805

2330 Saint Mary St W FL
1 SH Urology
Lewisburg, PA 17837-8805
Phone (570) 522-8328

416 S Main St
Mansfield, PA 16933-1510

700 High St
Williamsport, PA 17701-3100

700 High St
Williamsport, PA 17701-3198

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Aug 15, 2022 Accepting new patients
Susquehanna Physician Services Physician Assistant CurrentSince Aug 15, 2022 Accepting new patients

Locations

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

1201 Grampian Blvd
Ste 2F
Williamsport, PA 17701
Phone (570) 320-7598

1705 Warren Ave
Ste 101103
Williamsport, PA 17701

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: ebenjamin36744@upmc.direct-ci.com
  • Direct secure messaging: erik.benjamin@upmcdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1205568193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "888-647-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE STE 101-103",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012647",
            "telephone_number": "570-321-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "ERIK",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.