NPIMap

Organization Active NPI

Peninsula Pathology Associates, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Salisbury, MD
National Provider Identifier
1386738144
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PENINSULA PATHOLOGY ASSOCIATES, PA
Practice address
100 East Carroll Street
Salisbury, MD 21801-5493
Phone
(410) 546-6400
NPI assigned
Oct 3, 2006
Last updated
Oct 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Dr. Timothy L Benning, MDNPI 1528141538
Title
President
Phone
(410) 546-6400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZC0500X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

100 East Carroll Street
Salisbury, MD 21801-5493

Mailing address

100 East Carroll Street
Salisbury, MD 21801-5493
Phone (410) 546-6400

Other identifiers 3

IdentifierTypeStateIssuer
R807OtherDCGHI
S445OtherMDBLUE SHIELD
CI9177OtherMDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060301000361 MD Part B Supplier - Clinic/Group Practice 4880600204 Receives reassigned benefits from 5 practitioners
Practice locations: Salisbury, MD
O20070827000421 DE Part B Supplier - Clinic/Group Practice 4880600204 Receives reassigned benefits from 5 practitioners
Practice locations: Seaford, DE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1386738144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EAST CARROLL STREET",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015493",
            "telephone_number": "410-546-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EAST CARROLL STREET",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015493",
            "telephone_number": "410-546-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PATHOLOGY ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "BENNING",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-546-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "R807",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "S445",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI9177",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.