Individual provider Active NPI

Edmond A. Bendaly, M.D.

  • Hematology & Oncology Physician
  • Marion, IN
National Provider Identifier
1285835652
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
P51816 Issued in NY
Practice address
831 Theatre Drive
Marion, IN 46952-1701
Phone
(765) 660-7800
Fax
(765) 662-4470
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion General Hospital 115 clinicians

Practice addresses (Care Compare)

831 N Theatre Dr
Marion, IN 46952-1701
Phone (765) 660-7800

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, IN, CCN 150011

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20090807000211 IN Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8426101528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P51816NYMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marion General Hospital CurrentSince Jul 1, 2009 Accepting new patients
Marion General Hospital CurrentSince Jul 1, 2009 Accepting new patients

Locations

911 Marion Health Dr
Gas City, IN 46933
Phone (765) 660-7000

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

831 N Theatre Dr
Marion, IN 46952
Phone (765) 660-7800

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X P51816 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

831 Theatre Drive
Marion, IN 46952-1701

Mailing address

330 North Wabash
Suite G20
Marion, IN 46952-2600
Phone (765) 662-4133

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
000000620997OtherINANTHEM
200948330MedicaidIN

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address edmond.bendaly@mgh.eclinicaldirectplus.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 20, 2020.

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1285835652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 NORTH WABASH",
            "address_2": "SUITE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-662-4133",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 THEATRE DRIVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469521701",
            "telephone_number": "765-660-7800",
            "fax_number": "765-662-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDALY",
        "first_name": "EDMOND",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "P51816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000620997",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200948330",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edmond.bendaly@mgh.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "831 Theatre Drive",
            "city": "Marion",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469521701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.