Individual provider Active NPI

Randy E Benish, PA-C

  • Medical Physician Assistant
  • Wichita Falls, TX
National Provider Identifier
1215905617
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA01374 Issued in TX
Practice address
4007 Call Field Rd Ste E
Wichita Falls, TX 76308-2679
Phone
(940) 264-2625
Fax
(940) 264-6401
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA01374 TX Primary

Addresses

Primary practice location

4007 Call Field Rd Ste E
Wichita Falls, TX 76308-2679

Mailing address

4007 Call Field Rd Ste E
Wichita Falls, TX 76308-2679
Phone (940) 264-2625

Other identifiers 1

IdentifierTypeStateIssuer
S10774OtherTXUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120820000204 TX Practitioner - Physician Assistant 9537321278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texoma Rheumatology PLLCGroup PAC ID 4789095043, 4 clinicians

Practice addresses (Care Compare)

4007 Call Field Rd
Suite E
Wichita Falls, TX 76308-2679
Phone (940) 264-2625

Hospital & facility affiliations

  • United Regional Health Care System Hospital, Wichita Falls, TX, CCN 450010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1617TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Summit Medical Center Past Accepting new patients
Orthopaedic Associates, LLP Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: rbenish62578@unitedregional.medalliesdirect.net
  • Direct secure messaging: randy.benish.1@24478.direct.athenahealth.com
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: randybenishpa@txrheum.azalea.phimailbox.com

Organizations & group practices 6

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 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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1215905617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 CALL FIELD RD STE E",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082679",
            "telephone_number": "940-264-2625",
            "fax_number": "940-264-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 CALL FIELD RD STE E",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082679",
            "telephone_number": "940-264-2625",
            "fax_number": "940-264-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENISH",
        "first_name": "RANDY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "S10774",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.