Individual provider Active NPI

Bennie William Muscha, MD

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1255369104
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42575 Issued in AZ
Practice address
1917 South Crismon Road
Mesa, AZ 85206
Phone
(480) 610-7100
Fax
(480) 610-7115
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6633 ND
Family Medicine Physician 207Q00000X 42575 AZ Primary

Addresses

Primary practice location

1917 South Crismon Road
Mesa, AZ 85206

Mailing address

1917 South Crismon Road
Mesa, AZ 85206
Phone (480) 610-7100

Other identifiers 2

IdentifierTypeStateIssuer
11681OtherNDBCBS
17619MedicaidND

Other names 1

  • Ben W Muscha Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051114000626 ND Practitioner - Family Practice 2961467055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6633NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Charity Association Current Accepting new patients
Lutheran Charity Association CurrentSince Apr 1, 2016 Accepting new patients
Lutheran Charity Association CurrentSince Apr 1, 2016 Accepting new patients
Carrington Health Center Family Medicine Past Accepting new patients
Carrington Health Center Family Medicine Past Accepting new patients

Locations

2422 20th St SW
Jamestown, ND 58401
Phone (701) 252-1050

Organizations & group practices 5

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1255369104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 SOUTH CRISMON ROAD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 SOUTH CRISMON ROAD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-610-7100",
            "fax_number": "480-610-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSCHA",
        "first_name": "BENNIE",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "6633",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "42575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11681",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17619",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEN",
            "last_name": "MUSCHA",
            "middle_name": "W",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.