Jonathan James Benak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15143 Issued in CA

Practice address

615 Ocean St
Santa Cruz, CA 95060-4005

Phone

(831) 425-7991

Fax

(831) 425-7346

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19797/brand/1/csg/1/fhir/r4
• Direct secure messaging: jbenak18624@direct.svmh.com

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.

• Capital Medical Extended Care

  • Skilled Nursing Facility
  • Sacramento, CA
  • NPI 1295131092
  NPD (past)
• Mdstat Urgent Care, Inc

  dba MD Stat Urgent Care

  • Urgent Care Clinic/Center
  • Roseville, CA
  • NPI 1407229107
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1336179852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 OCEAN ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604005",
            "telephone_number": "831-425-7991",
            "fax_number": "831-425-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 OCEAN ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604005",
            "telephone_number": "831-425-7991",
            "fax_number": "831-425-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAK",
        "first_name": "JONATHAN",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA15143",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Beltran
• Heather Lee Beltran
• Jose Beltran
• Louis Alberto Beltran
• Bailey Brianne Benado, MSOT, OTR/L
• Savannah Benefield
• Marianne Benforado, L.AC
• Lydia Jamie Benga
• Nicole Benjamin
• Jonathan Coleman Benko, LCSW

• Physician Assistant in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.