NPIMap

Individual provider Active NPI

Michael James Bentze, DO

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1407840622
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS9174 Issued in FL
Practice address
11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone
(941) 538-0001
Fax
(941) 538-0002
NPI assigned
Sep 2, 2005
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS9174 FL Primary

Addresses

Primary practice location

11715 Rangeland Pkwy
Bradenton, FL 34211-9529

Mailing address

11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone (941) 538-0001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Michael.Bentze@img.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014001080 FL Practitioner - Family Practice 9638139736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone (941) 538-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS9174FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Family Medicine CurrentSince Sep 23, 2021 Accepting new patients
Intercoastal Medical Group Inc Family Medicine CurrentSince Sep 1, 2006 Accepting new patients
Family Medicine Specialists, PLLC Family Medicine PastSince Sep 1, 2004 Accepting new patients

Locations

11715 Rangeland Pkwy
Bradenton, FL 34211
Phone (941) 538-0001

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70573
  • Direct secure messaging: michael.bentze@img.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1407840622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11715 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119529",
            "telephone_number": "941-538-0001",
            "fax_number": "941-958-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119529",
            "telephone_number": "941-538-0001",
            "fax_number": "941-538-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTZE",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Michael.Bentze@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11715 Rangeland Pkwy",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342119529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.