Sandra Lorena Benitez Kruidenier, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61115668 Issued in WA

Practice address

1221 Madison St
Ste 1020
Seattle, WA 98104-1380

Phone

(206) 215-2658

Fax

(206) 991-2363

NPI assigned

Nov 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sandra Lorena Benitez Other name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbenitezkruidenier213892@direct.seattlechildrens.org

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.

• Seattle Children's Hospital

  • Specialist
  • Seattle, WA
  • NPI 1003319500
  Medicare reassignment
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment
• Seattle Children's Hospital

  • Children's Hospital
  • Seattle, WA
  • NPI 1467536276
  NPD
• Seattle Childrens Hospital

  dba Seattle Childrens Outpatient Pharmacy

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• Seattle Children's Hospital

  • Home Infusion Agency
  • Bothell, WA
  • NPI 1245383348
  NPD (past)
• Clinica Campesina Family Health Services

  dba Clinica Campesina - Thornton

  • Federally Qualified Health Center (FQHC)
  • Thornton, CO
  • NPI 1093702177
  NPD (past)

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1255874079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MADISON ST",
            "address_2": "STE 1020",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041380",
            "telephone_number": "206-215-2658",
            "fax_number": "206-991-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ KRUIDENIER",
        "first_name": "SANDRA",
        "middle_name": "LORENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61115668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255874079",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "BENITEZ",
            "middle_name": "LORENA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sara Bengsch
• Catherine Beni
• Stephen K Benirschke, MD
• David Francis Benishek, MA, NA, RC
• Moises Benitez - Martinez, REG DENTAL HYGIENIST
• Elias Ray Benitez Jr., MD
• Sara G Benitez, PA-C
• Benjamin Chang LLC
• Benjamin Kang, DDS, PHD, PLLC
• Benjamin L Chang, DDS PS (Greenlake Dental)

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.