Individual provider Active NPI

William A Bennett, DPM

  • Podiatrist
  • North Bend, OR
National Provider Identifier
1407906654
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DP00270 Issued in OR
Practice address
2085 Inland Dr
Suite B
North Bend, OR 97459-1203
Phone
(541) 756-3332
Fax
(541) 756-2370
NPI assigned
Jan 11, 2007
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P000000561 WA
Podiatrist 213E00000X DP00270 OR Primary

Addresses

Primary practice location

2085 Inland Dr
Suite B
North Bend, OR 97459-1203

Mailing address

2085 Inland Dr
Suite B
North Bend, OR 97459-1203
Phone (541) 756-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
O20110222000957 OR DME Supplier - Physician - Podiatry 1759562812 Practice locations: North Bend, OR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2085 Inland Dr
Suite B
North Bend, OR 97459-1203
Phone (541) 756-3332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.84 of 100Reported as individual
Quality
53.7
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue66
Removal of nail tissue2451
Removal or shaving of skin growth1184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P000000561WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Coast Podiatry, LLC Podiatrist Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7006/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1407906654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 INLAND DR",
            "address_2": "SUITE B",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591203",
            "telephone_number": "541-756-3332",
            "fax_number": "541-756-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 INLAND DR",
            "address_2": "SUITE B",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974591203",
            "telephone_number": "541-756-3332",
            "fax_number": "541-756-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "P000000561",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, OR

Sources for this page

Verify at the official NPI Registry.