Individual provider Active NPI

Oscar Benavides, MD

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1356493977
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H9039 Issued in TX
Practice address
209 W Village Blvd
Ste 11
Laredo, TX 78041-2227
Phone
(956) 725-5210
Fax
(956) 717-1708
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H9039 TX Primary

Addresses

Primary practice location

209 W Village Blvd
Ste 11
Laredo, TX 78041-2227

Mailing address

209 W Village Blvd
Ste 11
Laredo, TX 78041-2227
Phone (956) 725-5210

Other identifiers 2

IdentifierTypeStateIssuer
1371882-02MedicaidTX
1924631-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000963 TX Practitioner - Family Practice 3274529789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

209 W Village Blvd
Suite 11
Laredo, TX 78041-2227
Phone (956) 725-5210

Hospital & facility affiliations

  • St. Jude'S Specialty Home and Health Care Services, Inc. Home health agency, Laredo, TX, CCN 747388
  • Doctors Hospital of Laredo Hospital, Laredo, TX, CCN 450643
  • Laredo Medical Center Hospital, Laredo, TX, CCN 450029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H9039TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oscar Benavides MD PA Family Medicine CurrentSince Oct 7, 1999 Accepting new patients
City of Laredo Past Accepting new patients

Locations

209 W Village Blvd
Ste 3
Laredo, TX 78041
Phone (210) 725-5210

209 W Village Blvd
Ste 11
Laredo, TX 78041
Phone (956) 725-5210

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1356493977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W VILLAGE BLVD",
            "address_2": "STE 11",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412227",
            "telephone_number": "956-725-5210",
            "fax_number": "956-717-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W VILLAGE BLVD",
            "address_2": "STE 11",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412227",
            "telephone_number": "956-725-5210",
            "fax_number": "956-717-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDES",
        "first_name": "OSCAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H9039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371882-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1924631-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.