Individual provider Active NPI

Travis Stewart Benesch-Rupp, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1417359852
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4455 E 12TH Ave
Denver, CO 80220-2415
Phone
(303) 504-6500
NPI assigned
Sep 17, 2014
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

4455 E 12TH Ave
Denver, CO 80220-2415

Mailing address

4455 E 12TH Ave
Denver, CO 80220-2415
Phone (303) 504-7700

Other practice location 1

30 Warren St
Brighton, MA 02135-3602
Phone (617) 254-3800 ext. 3040

Other names 1

  • Travis Stewart Benesch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200415000463 CO Practitioner - Clinical Social Worker 9638509649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Center of DenverGroup PAC ID 3476440314, 87 clinicians

Practice addresses (Care Compare)

4141 E Dickenson PL
Denver, CO 80222-6012
Phone (303) 504-6500

4455 E 12TH Ave
Denver, CO 80220-2415
Phone (303) 504-7700

Merit-based Incentive Payment System (MIPS)

Final score
60.28 of 100Reported as group
Quality
23.87
Improvement activities
40
Cost
82.48

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Denver CurrentSince Feb 24, 2020 Accepting new patients
Mental Health Center of Denver Current Accepting new patients
Mental Health Center of Denver CurrentSince Feb 24, 2020 Accepting new patients

Locations

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509

4455 E 12th Ave
Denver, CO 80220
Phone (303) 504-7799

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1417359852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E 12TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802202415",
            "telephone_number": "303-504-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Warren St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353602",
            "country_code": "US",
            "telephone_number": "617-254-3800 x3040",
            "fax_number": "617-779-1235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENESCH-RUPP",
        "first_name": "TRAVIS",
        "middle_name": "STEWART",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAVIS",
            "last_name": "BENESCH",
            "middle_name": "STEWART",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.