Individual provider Active NPI

Benzion G Goldwyn, M.D.

  • Otolaryngology Physician
  • Sacramento, CA
National Provider Identifier
1265543599
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G83072 Issued in CA
Practice address
2725 Capitol Ave
Suite 404
Sacramento, CA 95816-6004
Phone
(916) 262-9456
Fax
(916) 262-9460
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G83072 CA Primary

Addresses

Primary practice location

2725 Capitol Ave
Suite 404
Sacramento, CA 95816-6004

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
00G830720MedicaidCA

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
I20081210000895 CA Practitioner - Otolaryngology 8426119330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Washington School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G83072CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Otolaryngology Current Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Rideout Memorial Hospital Past Accepting new patients
Sutter North Medical Foundatoin Past Accepting new patients

Locations

2725 Capitol Ave
Dept 404
Sacramento, CA 95816
Phone (916) 262-9456

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2725 Capitol Ave
Sacramento, CA 95816
Phone (916) 262-9370

Interoperability endpoints

  • Direct secure messaging: bgoldwynmd29780@hisp.ehr.sutterhealth.org

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.

Hospital & facility affiliations 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1265543599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 CAPITOL AVE",
            "address_2": "SUITE 404",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958166004",
            "telephone_number": "916-262-9456",
            "fax_number": "916-262-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDWYN",
        "first_name": "BENZION",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G83072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G830720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.