Active NPI
Max P Benzaquen, MD
- Neurology Physician
- Chesterfield, MO
National Provider Identifier
1366426900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 100507
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 187999 | Other | HEALTHLINK | |
| 10730 | Other | BC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100507 | MO | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- Specialist
- Chesterfield, MO
- NPI 1992836134
-
- Emergency Medicine Physician
- Saint Charles, MO
- NPI 1427002922
-
- Emergency Medical Services (Emergency Medicine) Physician
- Lake St Louis, MO
- NPI 1538113097
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.