Cody Michael Benedict, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

3756 Issued in MN

Practice address

110 Evergreen SQ SW
Pine City, MN 55063-2000

Phone

(320) 629-7262

NPI assigned

Nov 20, 2020

Last updated

Feb 25, 2022By 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

Other names 1

• Dr. Cody M Benedict Professional name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagan Eye Clinic LLCGroup PAC ID 0345220745, 48 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Eagan Eye Clinic LLC

  • Optometrist
  • Eagan, MN
  • NPI 1477732337
  Medicare reassignment Care Compare group NPD
• Eagan Eye Clinic LLC

  • Optometrist
  • Becker, MN
  • NPI 1023615069
  NPD
• St Croix Falls Eye Associates

  dba Grantsburg Eye Associates

  • Optometrist
  • Grantsburg, WI
  • NPI 1174653133
  NPD

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1376146373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 OAK ST W UNIT 1",
            "city": "FREDERIC",
            "state": "WI",
            "postal_code": "548378902",
            "telephone_number": "715-566-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EVERGREEN SQ SW",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550632000",
            "telephone_number": "320-629-7262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8251 Flying Cloud Dr",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553445350",
            "country_code": "US",
            "telephone_number": "952-829-7812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "CODY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3756",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3652-35",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CODY",
            "last_name": "BENEDICT",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "O.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Avalon Meridian Behavioral Health
• B&B Guardian Angels Home Care Services, Inc
• Del Gene Bacon, LADC
• Balanced Integrative Health
• Calli Benedict, O.D
• Sadie Christine Binger, RN
• Christina M Blaiser, R.N.
• Joel Steven Blomberg, DC
• Michael Bousu, MA, LMFT
• Larry Brackenbury

• Optometrist in Pine City, MN
• Providers in Pine City, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.