Active NPI
Jason B. Bennett, M.D.
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- License
- 4301076635
- Practice address
- 770 Kenmoor Ave SE Ste 301
Grand Rapids, MI 49546-8621 - Phone
- (616) 290-1876
- Fax
- (616) 290-1877
- NPI assigned
- Jul 24, 2006
- 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 |
|---|---|---|---|---|
| Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | 207VF0040X | 4301076635 | MI | Primary |
Addresses
Primary practice location
770 Kenmoor Ave SE Ste 301
Grand Rapids, MI 49546-8621
Mailing address
770 Kenmoor Ave SE Ste 301
Ste 301
Grand Rapids, MI 49546-8621
Phone (616) 290-1876
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Michigan State University College of Human Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Center for Physical Rehabilitation Inc
Practice addresses (Care Compare)
5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808
5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808
770 Kenmoor Ave SE
Suite 301
Grand Rapids, FL 49546-8621
Hospital & facility affiliations
- Spectrum Health
- Mercy Health Saint Mary'S
- Trinity Health Muskegon Hospital
- Charlevoix Area Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301076635 | MI | MD | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bennett Institute for Urogynecology and Incontinence PC | Urogynecology and Reconstructive Pelvic Surgery | Current | Accepting new patients |
| Oam Surgery Center at Midtowne, LLC | Past | Accepting new patients |
Locations
770 Kenmoor Ave SE
Ste 301
Grand Rapids, MI 49546
Phone (616) 252-4407
5060 Cascade Rd SE
Ste C-1
Grand Rapids, MI 49546
Phone (616) 255-9521
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 and National Provider Directory roles.
-
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- Grand Rapids, MI
- NPI 1790410991
-
- Physical Therapy Clinic/Center
- Grand Rapids, MI
- NPI 1902288863
-
- Ambulatory Surgical Clinic/Center
- Grand Rapids, MI
- NPI 1134363690
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Muskegon, MI
- NPI 1831132133
-
- Critical Access Hospital
- Charlevoix, MI
- NPI 1346260692
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780617600000",
"number": "1295757631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 KENMOOR AVE SE STE 301",
"address_2": "STE 301",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468621",
"telephone_number": "616-290-1876",
"fax_number": "616-290-1876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 KENMOOR AVE SE STE 301",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468621",
"telephone_number": "616-290-1876",
"fax_number": "616-290-1877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "JASON",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2026-06-05",
"certification_date": "2026-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207VF0040X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
"state": "MI",
"license": "4301076635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.