Individual provider Active NPI

Olga Benitez, MD

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1275741209
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MAO4621800 Issued in NJ
Practice address
73 Ferry St
Newark, NJ 07105-1831
Phone
(973) 230-9223
Fax
(973) 230-9225
NPI assigned
May 21, 2007
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MAO4621800 NJ Primary

Addresses

Primary practice location

73 Ferry St
Newark, NJ 07105-1831

Mailing address

73 Ferry St BSMT
Newark, NJ 07105-1831
Phone (201) 655-1906

Other identifiers 1

IdentifierTypeStateIssuer
8443505MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20071119000238 NJ Practitioner - Internal Medicine 4486742848 Practice locations: Newark, NJ

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MAO4621800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Trinity Family Practice& Gynecology Center LLC PastSince Mar 20, 2022 Accepting new patients
Ars Treatment Centers of New Jersey, PC PastSince Jan 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: olga.benitez@direct.hobokenumc.md
  • Direct secure messaging: olga.benitez@olgabenitezmd.ehi.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1275741209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 FERRY ST BSMT",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051831",
            "telephone_number": "201-655-1906",
            "fax_number": "973-230-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051831",
            "telephone_number": "973-230-9223",
            "fax_number": "973-230-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MAO4621800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8443505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.