Guy Richard Bennallack Jr., DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

S3795 Issued in TX

Practice address

1400 E Church St BLDG 8
Santa Maria, CA 93454

Phone

(805) 739-3561

NPI assigned

Jun 3, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, TX, HI3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency MedicineAlso: Osteopathic Manipulative Medicine

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pearsall Emergency Medicine Associates, PAGroup PAC ID 1557623147, 45 clinicians

Santa Ynez River Physicians PCGroup PAC ID 7911241229, 21 clinicians

Hawaii Emergency Physicians Associated IncGroup PAC ID 2860390283, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lompoc Valley Medical Center Hospital, Lompoc, CA, CCN 050110
• The Hospitals of Providence Horizon City Campus Hospital, Horizon City, TX, CCN 670124

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Santa Ynez River Physicians, PC

  • Emergency Medicine Physician
  • Lompoc, CA
  • NPI 1396210597
  Medicare reassignment Care Compare group NPD
• Hawaii Emergency Physicians Associated Inc

  • Emergency Medicine Physician
  • Kailua, HI
  • NPI 1801843198
  Medicare reassignment Care Compare group NPD
• Pearsall Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Horizon City, TX
  • NPI 1104326263
  Medicare reassignment Care Compare group NPD
• Cep America - California

  • Emergency Medicine Physician
  • San Francisco, CA
  • NPI 1023063542
  Medicare reassignment NPD
• Bluff Creek Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • El Paso, TX
  • NPI 1679071690
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Texas - Houston, PLLC

  • Emergency Medicine Physician
  • Plainview, TX
  • NPI 1760028740
  Medicare reassignment NPD
• Cep America - California

  • Emergency Medicine Physician
  • Marysville, CA
  • NPI 1730134289
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• HCN Ep Horizon City, LLC

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1861994808
  NPD (past)
• Midpacific Hospitalists LLC

  • Internal Medicine Physician
  • Kailua, HI
  • NPI 1053778217
  NPD (past)

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

• Lompoc Valley Medical Center

  • General Acute Care Hospital
  • Lompoc, CA
  • NPI 1194711952
  Care Compare affiliation
• HCN Ep Horizon City, LLC

  • General Acute Care Hospital
  • Horizon City, TX
  • NPI 1003344334
  Care Compare affiliation
• HCN Ep Horizon City, LLC

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1275473340
  Care Compare affiliation
• HCN Ep Horizon City, LLC

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1841843455
  Care Compare affiliation
• HCN Ep Horizon City, LLC

  • General Acute Care Hospital
  • El Paso, TX
  • NPI 1861994808
  Care Compare affiliation

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1245610344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E CHURCH ST BLDG 8",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934545906",
            "telephone_number": "805-739-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E CHURCH ST BLDG 8",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-739-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNALLACK",
        "first_name": "GUY",
        "middle_name": "RICHARD",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S3795",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A15415",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "XXXXXXXXXX",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary S Benedetti, DDS
• Paramjit Singh Benipal, MD
• Alejandro Benitez-Olivera
• Elizabeth Benko, FNP-C
• Megan Elizabeth Benn
• Sandra Jean Benny
• Edward Benson, M.D.
• David Bentley
• Wendy L Beres
• Mary Bergholz

• Family Medicine Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.