Individual provider Active NPI

Benjamin Joseph Rispoli, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1245885714
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023715 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-4321
NPI assigned
Aug 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 023715 NY
Physician Assistant 363A00000X 023715 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

9420 Guy R Brewer Blvd
Jamaica, NY 11451-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190926002581 NY Practitioner - Physician Assistant 6002146438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023715NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Aug 16, 2019 Accepting new patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince May 12, 2025 Accepting new patients
Montefiore Medical Center CurrentSince Aug 16, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

300 Community Dr
Manhasset, NY 11030

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1245885714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 GUY R BREWER BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114510001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISPOLI",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-01",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "023715",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.