Individual provider Active NPI

Benjamin Henry Hubbard, PA-C

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1407447345
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00713000 Issued in NJ
Practice address
4735 Ogletown Stanton Rd Ste 3301
Newark, DE 19713-7021
Phone
(302) 623-4370
NPI assigned
Feb 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C50011591 DE
Physician Assistant 363A00000X MA062771 PA
Physician Assistant 363A00000X 25MP00713000 NJ Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd Ste 3301
Newark, DE 19713-7021

Mailing address

200 Hygeia Dr Ste 2300
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, NJ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211015002781 DE Practitioner - Physician Assistant 4880092196 Reassigns benefits to 1 organization
I20211118000020 MD Practitioner - Physician Assistant 4880092196 Reassigns benefits to 2 organizations
I20220719001755 NJ Practitioner - Physician Assistant 4880092196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (856) 513-4124

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 513-4124

2211 Chapel Ave W
301 Kha General Surgery
Cherry Hill, NJ 08002-2048
Phone (856) 665-2017

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

457 Haddonfield Rd
Suite 110
Cherry Hill, NJ 08002-2223
Phone (844) 542-2273

Hospital & facility affiliations

  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C50011591DEMDPhysician Assistant
25MP00713000NJMDPhysician Assistant
MA062771PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital of Cecil County CurrentSince Dec 15, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Jul 8, 2022 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jul 8, 2022 Accepting new patients
Union Hospital of Cecil County Inc CurrentSince Dec 15, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 1, 2025 Accepting new patients
Christiana Care Health Services Inc CurrentSince Oct 4, 2021 Accepting new patients
Christiana Care Health Services, Inc Physician Assistant CurrentSince Oct 4, 2021 Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 3301
Newark, DE 19713
Phone (302) 623-4370

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1407447345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 3301",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197137021",
            "telephone_number": "302-623-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "BENJAMIN",
        "middle_name": "HENRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-02",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C50011591",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062771",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00713000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.