Michael John Benyo, OD
Individual provider Active NPI Optometrist · Sayre, PA
NPI 1407825490 · NPPES record last updated Mar 5, 2021
Key facts
- NPI
- 1407825490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OEG000948 (PA)
- Practice address
- 1 Guthrie SQ
Sayre, PA 18840-1625 - Phone
- (570) 888-5858
- Fax
- (570) 887-3236
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Guthrie Medical Group PC
Practice addresses (Care Compare)
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
1159 Vestal Ave
Binghamton, NY 13903-1606
Phone (607) 722-1755
130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971
One Guthrie SQ
Sayre, PA 18840-1625
One Guthrie Square
Sayre, PA 18840-1625
Hospital & facility affiliations
- Robert Packer Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101103000890 | NY | Practitioner - Optometry | 5597959551 | Reassigns benefits to 1 organization |
| I20111019000435 | PA | Practitioner - Optometry | 5597959551 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TUV004754-1 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrhie Medical Group, P.C. | Optometrist | Current |
Accepting new patients |
| Guthrie Medical Group, P.C. | Current |
Accepting new patients | |
| Guthrie Medical Group, P.C. | Current | Accepting new patients | |
| Guthrie Medical Group, P.C. | Current |
Accepting new patients | |
| Guthrie Clinic LTD | Past | Accepting new patients | |
| Guthrie Medical Group, P.C. | Past | Accepting new patients |
Locations
130 Center Way
Corning, NY 14830
Phone (607) 936-9971
1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106
Interoperability endpoints
- mbenyo8104@direct-guthrie.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000948 | PA | Yes |
| Optometrist | 152W00000X | TUV004754-1 | NY |
Addresses
Primary practice location
1 Guthrie SQ
Sayre, PA 18840-1625
Mailing address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410043463 | Other | PA | RR MEDICARE PIN |
| 0011014560001 | Medicaid | PA | |
| 01054920 | Medicaid | NY | |
| CC8362 | Other | NY | RR MEDICARE GROUP |
| GU039785 | Other | PA | MEDICARE GROUP |
| P00324442 | Other | NY | RR MEDICARE PIN |
| CC9269 | Other | PA | RR MEDICARE GROUP |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | XXXXXX@direct-guthrie.org | Direct | |
| Direct Messaging Address | mbenyo8104@direct-guthrie.org | Direct |
Other providers in Sayre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.