Individual provider Active NPI

Benjamin Thomas Judd, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • York, PA
National Provider Identifier
1285132878
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA059686 Issued in PA
Practice address
2149 S Queen St
York, PA 17403-4845
Phone
(717) 356-4460
Fax
(717) 260-3326
NPI assigned
Jan 29, 2018
Last updated
Sep 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA059686 PA Primary

Addresses

Primary practice location

2149 S Queen St
York, PA 17403-4845

Mailing address

2149 S Queen St
York, PA 17403-4845
Phone (717) 356-4460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180220001654 PA Practitioner - Physician Assistant 0547521239 Reassigns benefits to 1 organization
I20210426001142 MD Practitioner - Physician Assistant 0547521239 Reassigns benefits to 7 organizations
I20230920001848 DC Practitioner - Physician Assistant 0547521239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA059686PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Observation Services LLC CurrentSince Jan 1, 2022 Accepting new patients
Wellspan Medical Group CurrentSince Sep 16, 2019 Accepting new patients
Centennial Medical Group, PA Current Accepting new patients
Wellspan Medical Group CurrentSince Sep 16, 2019 Accepting new patients
WHC Emerg Phys CurrentSince Jul 1, 2023 Accepting new patients
Centennial Medical Group, PA CurrentSince Jan 29, 2024 Accepting new patients
First Call Medical Center LLC CurrentSince Jan 29, 2024 Accepting new patients
Christiana Care Quality Partners PastSince Aug 1, 2021 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200

6230 Old Dobbin Ln
Ste 230
Columbia, MD 21045
Phone (443) 312-2111

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

10981 Johns Hopkins Rd
Laurel, MD 20723
Phone (410) 694-7999

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733

1600 S George St
York, PA 17403
Phone (717) 848-3615

2149 S Queen St
York, PA 17403
Phone (717) 356-4460

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1285132878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 S QUEEN ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034845",
            "telephone_number": "717-356-4460",
            "fax_number": "717-260-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 S QUEEN ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034845",
            "telephone_number": "717-356-4460",
            "fax_number": "717-260-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "BENJAMIN",
        "middle_name": "THOMAS",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-29",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.