Individual provider Active NPI

Hunter David Benvenuti

  • Surgery Physician
  • Fresno, CA
National Provider Identifier
1255750147
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1255750147 Issued in CO
Practice address
155 N Fresno St
Fresno, CA 93701-2302
Phone
(559) 459-5196
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 1255750147 CO
Surgery Physician 208600000X 1255750147 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

155 N Fresno St
Fresno, CA 93701-2302

Mailing address

155 N Fresno St
Fresno, CA 93701-2302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230808003403 CA Practitioner - Plastic and Reconstructive Surgery 0042672081 Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
New York Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

355 Placentia Ave
Suite 104
Newport Beach, CA 92663-3301
Phone (949) 650-2345

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision39
Removal of tissue17
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1255750147COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mariners Surgicenter Past Accepting new patients
David Benvenuti, M.D. F.a.C.S. Past Accepting new patients

Organizations & group practices 2

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 4

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1255750147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012302",
            "telephone_number": "559-459-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENVENUTI",
        "first_name": "HUNTER",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "1255750147",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "1255750147",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.