Nicholas J Bennett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002413A Issued in IN

Practice address

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Phone

(260) 203-9600

NPI assigned

Feb 16, 2018

Last updated

Feb 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1013194455

  IN

  Medicare reassignment Care Compare group NPD
• American Current Care P.a.

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD
• Innovative Hospital Care, LLC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1922374172
  NPD (past)

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1336649383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10343 DAWSONS CREEK BLVD STE A",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251906",
            "telephone_number": "260-203-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044140",
            "telephone_number": "260-203-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-16",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002413A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10002413A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Bennett, RBT
• Hunter Bennett, DPT
• Karen A Bennett
• Krista R Bennett, LAT, ATC
• Melissa Bennett, LPN
• Sara Bennett, RD
• Michele Bennington
• Dawn Benson, DDS
• Faith Onica Benson
• Frances Benson, RBT

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.

Verify at the official NPI Registry.