Active NPI
Ben Elchonen
- Home Health Aide
- Oak Park, MI
National Provider Identifier
1295455848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 9884723
- Practice address
- 25911 Stratford PL
Oak Park, MI 48237-1027 - Phone
- (646) 504-4236
- NPI assigned
- Sep 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 9884723 | MI | Primary |
Addresses
Primary practice location
25911 Stratford PL
Oak Park, MI 48237-1027
Mailing address
25911 Stratford PL
Oak Park, MI 48237-1027
Phone (646) 504-4236
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9884723 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9884723 | MI | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1295455848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25911 STRATFORD PL",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482371027",
"telephone_number": "646-504-4236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25911 STRATFORD PL",
"city": "OAK PARK",
"state": "MI",
"postal_code": "482371027",
"telephone_number": "646-504-4236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELCHONEN",
"first_name": "BEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-01",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MI",
"license": "9884723",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9884723",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.