Tucker D Benjamin, MS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005769 Issued in IL

Practice address

750 E Terra Cotta Ave Ste B
Crystal Lake, IL 60014-3621

Phone

(815) 759-6363

Fax

(815) 759-6360

NPI assigned

Mar 22, 2012

Last updated

Dec 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

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.

• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Advocate North Side Health Network

  dba Advocate Illinois Masonic Physician Group

  • Clinic/Center
  • Chicago, IL
  • NPI 1780788323
  NPD (past)
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Illinois Medical Center

  dba Centegra Hospital McHenry

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1407122591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E CONGRESS PKWY STE D",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146235",
            "telephone_number": "815-759-6363",
            "fax_number": "815-759-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE B",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "815-759-6363",
            "fax_number": "815-759-6360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 E Congress Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600146235",
            "country_code": "US",
            "telephone_number": "815-759-6363",
            "fax_number": "815-759-6360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "TUCKER",
        "middle_name": "D",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shauna Bell, MOT, OTR/L
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• Bennett & Bennett
• Durie T Bennett, MA LCPC
• Torrie Benson-Pryor
• Bronte Benson
• Kimberley A Bentele, APRN, CNP

• Physician Assistant in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.