Individual provider Active NPI

Lawrence S. Benjamin, PA-C

  • Physician Assistant
  • Enfield, CT
National Provider Identifier
1316598709
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7274 Issued in MA
Practice address
875 Enfield St
Enfield, CT 06082-3617
Phone
(860) 741-3014
NPI assigned
Sep 26, 2019
Last updated
Dec 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA7274 MA Primary
Physician Assistant 363A00000X 4605 CT

Addresses

Primary practice location

875 Enfield St
Enfield, CT 06082-3617

Mailing address

18 Union St
West Springfield, MA 01089-3317
Phone (413) 781-0100

Other names 1

  • Lawrence Todd Sherrer Jr. Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20191121003086 CT Practitioner - Physician Assistant 5092147587 Reassigns benefits to 1 organization
I20210828000041 MA Practitioner - Physician Assistant 5092147587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 Cooley St
Unit 3
Springfield, MA 01128-1149
Phone (413) 782-4878

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4605CTMDPhysician Assistant
PA7274MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Children's Specialty Group, Inc. Physician Assistant CurrentSince Nov 1, 2019 Accepting new patients
Afc Physicians of Massachusetts, PC CurrentSince Aug 1, 2021 Accepting new patients
Afc Physicians of Massachusetts CurrentSince Aug 1, 2021 Accepting new patients

Locations

10 Columbus Blvd
Hartford, CT 06106
Phone (860) 837-5619

282 Washington St
Hartford, CT 06106
Phone (860) 545-8950

415 Cooley St
Unit 3
Springfield, MA 01128
Phone (413) 782-4878

18 Union St
West Springfield, MA 01089
Phone (413) 781-0100

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1316598709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 UNION ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893317",
            "telephone_number": "413-781-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 ENFIELD ST",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060823617",
            "telephone_number": "860-741-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "LAWRENCE",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-26",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7274",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4605",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAWRENCE",
            "last_name": "SHERRER",
            "middle_name": "TODD",
            "suffix": "JR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.