Active NPI
Michelle Suzanne Benson
- Perfusionist
- Menlo Park, CA
National Provider Identifier
1265796189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- F4377402
- Practice address
- 1670 El Camino Real
206
Menlo Park, CA 94025-4145 - Phone
- (650) 815-1922
- NPI assigned
- Jun 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | F4377402 | CA | Primary |
Addresses
Primary practice location
1670 El Camino Real
206
Menlo Park, CA 94025-4145
Mailing address
1670 El Camino Real
206
Menlo Park, CA 94025-4145
Phone (650) 815-1922
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F4377402 | CA | MD | Perfusionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1265796189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1670 EL CAMINO REAL",
"address_2": "206",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254145",
"telephone_number": "650-815-1922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 EL CAMINO REAL",
"address_2": "206",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254145",
"telephone_number": "650-815-1922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "MICHELLE",
"middle_name": "SUZANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-25",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "CA",
"license": "F4377402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.