Individual provider Active NPI

Kyle Benefield, O.D.

  • Optometrist
  • Spokane, WA
National Provider Identifier
1396133138
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 60508512 Issued in WA
Practice address
9652 N Newport Hwy
Spokane, WA 99218-1221
Phone
(509) 468-8080
NPI assigned
Jan 1, 2015
Last updated
May 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD 60508512 WA Primary

Addresses

Primary practice location

9652 N Newport Hwy
Spokane, WA 99218-1221

Mailing address

66 NW Boistfort St
Chehalis, WA 98532-2003
Phone (360) 748-6191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20200625003218 WA Practitioner - Optometry 9436571148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Van B Ly LLCGroup PAC ID 7416021639, 2 clinicians

Practice addresses (Care Compare)

66 NW Boistfort St
Chehalis, WA 98532-2003
Phone (360) 748-6191

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 60508512WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Van B. Ly, LLC CurrentSince May 20, 2020 Accepting new patients
America's Best Contacts & Eyeglasses Past Accepting new patients

Locations

66 NW Boistfort St
Chehalis, WA 98532
Phone (360) 748-6191

319 7th Ave SE
Ste 101
Olympia, WA 98501
Phone (360) 357-2544

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1420070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1396133138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 NW BOISTFORT ST",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322003",
            "telephone_number": "360-748-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9652 N NEWPORT HWY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181221",
            "telephone_number": "509-468-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEFIELD",
        "first_name": "KYLE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-01",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60508512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.