Individual provider Active NPI

Alexander Benenson, M.D., PH.D.

  • Nuclear Cardiology Physician
  • Brooklyn, NY
National Provider Identifier
1245328186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Cardiology PhysicianTaxonomy code 207UN0901X
License
171168 Issued in NY
Practice address
3043 Ocean Ave Ste 107
Brooklyn, NY 11235-3400
Phone
(718) 891-2727
Fax
(718) 891-2797
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X 171168 NY Primary

Addresses

Primary practice location

3043 Ocean Ave Ste 107
Brooklyn, NY 11235-3400

Mailing address

3043 Ocean Ave Ste 107
Brooklyn, NY 11235-3400
Phone (718) 891-2727

Other identifiers 5

IdentifierTypeStateIssuer
01166994MedicaidNY
511747OtherAETNA
0064305OtherNYGHI
KS476OtherNYOXFORD HEALTH PLAN
BKX0952-01OtherAMERICHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
171168NYMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metrocare Medical PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245328186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 OCEAN AVE STE 107",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353400",
            "telephone_number": "718-891-2727",
            "fax_number": "718-891-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 OCEAN AVE STE 107",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353400",
            "telephone_number": "718-891-2727",
            "fax_number": "718-891-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENENSON",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NY",
            "license": "171168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01166994",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "511747",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0064305",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "KS476",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "BKX0952-01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.