Individual provider Active NPI

Jonathan Christopher Benjamin, DO

  • Neuroradiology Physician
  • Philadelphia, PA
National Provider Identifier
1275158941
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
OT020018 Issued in PA
Practice address
111 S 11TH St Ste 2170
Philadelphia, PA 19107-4870
Phone
(215) 955-6000
NPI assigned
Jun 9, 2020
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X OT020018 PA Primary

Addresses

Primary practice location

111 S 11TH St Ste 2170
Philadelphia, PA 19107-4870

Mailing address

111 S 11TH St Ste 2170
Philadelphia, PA 19107-4870

Other practice location 1

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-8520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251126003115 PA Practitioner - Diagnostic Radiology 9133627862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rowan University School of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

5501 Old York Rd Community Prac Ctr
Philadelphia, PA 19141-3092
Phone (215) 456-6500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc CurrentSince Sep 18, 2025 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Sep 18, 2025 Accepting new patients

Locations

111 S 11th St
Ste 2170
Philadelphia, PA 19107
Phone (215) 955-2997

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1275158941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 2170",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST STE 2170",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074870",
            "telephone_number": "215-955-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "JONATHAN",
        "middle_name": "CHRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "OT020018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.