Individual provider Active NPI

Benjamin Francis Erhardt, M.D.

  • Otolaryngology Physician
  • Niles, MI
National Provider Identifier
1295096600
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301502578 Issued in MI
Practice address
2002 S 11TH St
Niles, MI 49120-4074
Phone
(269) 687-0200
NPI assigned
Jun 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD-44497 IA
Otolaryngology Physician 207Y00000X 4301502578 MI Primary

Addresses

Primary practice location

2002 S 11TH St
Niles, MI 49120-4074

Mailing address

2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200

Other practice location 1

1 Hospital Dr # Ma314
Columbia, MO 65201-5276
Phone (573) 882-6737

Other practice location 2

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8172

Other practice location 3

2710 Saint Francis Dr Ste 411
Waterloo, IA 50702-5634
Phone (319) 272-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200910003234 MI Practitioner - Otolaryngology 6709011810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Creighton University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200

2680 S Cleveland Ave
Saint Joseph, MI 49085-3002
Phone (269) 982-3368

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-44497IAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Oct 1, 2020 Accepting new patients
Lakeland Medical Practices CurrentSince Oct 1, 2020 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jan 25, 2023 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jan 25, 2023 Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients

Locations

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

2680 S Cleveland Ave
Saint Joseph, MI 49085
Phone (269) 428-9000

Interoperability endpoints

  • Direct secure messaging: berhardt1269350@epic00.corewelldirect.org

Organizations & group practices 5

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 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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1295096600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204074",
            "telephone_number": "269-687-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204074",
            "telephone_number": "269-687-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr # Ma314",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652015276",
            "country_code": "US",
            "telephone_number": "573-882-6737",
            "fax_number": "573-884-4205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1234 Napier Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "269-983-8172",
            "fax_number": "269-985-4535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2710 Saint Francis Dr Ste 411",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507025634",
            "country_code": "US",
            "telephone_number": "319-272-5000",
            "fax_number": "319-272-5825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERHARDT",
        "first_name": "BENJAMIN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-01",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IA",
            "license": "MD-44497",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301502578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.