Individual provider Active NPI

Max P Benzaquen, MD

  • Neurology Physician
  • Chesterfield, MO
National Provider Identifier
1366426900
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
100507 Issued in MO
Practice address
14377 Woodlake Dr Ste 308
Chesterfield, MO 63017-5735
Phone
(314) 878-8744
Fax
(314) 878-2234
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 100507 MO Primary

Addresses

Primary practice location

14377 Woodlake Dr Ste 308
Chesterfield, MO 63017-5735

Mailing address

14377 Woodlake Dr Ste 308
Chesterfield, MO 63017-5735
Phone (314) 878-8744

Other practice location 1

224 South Woods Mill Road
Suite 290 South
Chesterfield, MO 63017-3451
Phone (314) 878-8744

Other identifiers 2

IdentifierTypeStateIssuer
187999OtherHEALTHLINK
10730OtherBC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100507MOMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Max Benzaquen M D PC Current Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Ozarks Medical Center Neurology Past Accepting new patients

Locations

224 S Woods Mill Rd
Ste 290S
Chesterfield, MO 63017
Phone (314) 878-8744

Interoperability endpoints

  • Direct secure messaging: max.benzaquen@1807.securemail.mdnavigatorclinical.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1366426900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR STE 308",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-878-8744",
            "fax_number": "314-878-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR STE 308",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-878-8744",
            "fax_number": "314-878-2234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 SOUTH WOODS MILL ROAD",
            "address_2": "SUITE 290 SOUTH",
            "address_purpose": "LOCATION",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173451",
            "country_code": "US",
            "telephone_number": "314-878-8744",
            "fax_number": "314-878-2234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENZAQUEN",
        "first_name": "MAX",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "100507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "187999",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "10730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.