Individual provider Active NPI

Benjamin Daniel Naberhaus, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1417367970
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q2907 Issued in TX
Practice address
3600 Gaston Ave
Wadley 550
Dallas, TX 75246
Phone
(469) 800-7974
NPI assigned
May 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X Q2907 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
Wadley 550
Dallas, TX 75246

Mailing address

3600 Gaston Ave
Wadley 550
Dallas, TX 75246-1905
Phone (469) 800-7974

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bnaberhaus222030@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170726001437 TX Practitioner - Internal Medicine 7113142001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q2907TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine CurrentSince Nov 1, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 1, 2018 Accepting new patients
Concord Medical Group PLLC CurrentSince Jul 29, 2017 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jul 29, 2017 Accepting new patients
Baylor University Medical Center Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

3600 Gaston Ave
Ste 558
Dallas, TX 75246

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326

700 Walter Reed Blvd
Ste 203
Garland, TX 75042
Phone (972) 426-9900

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

Organizations & group practices 5

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 2

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": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1417367970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461905",
            "telephone_number": "469-800-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "WADLEY 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75246",
            "telephone_number": "469-800-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABERHAUS",
        "first_name": "BENJAMIN",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q2907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnaberhaus222030@direct.sw.org",
            "affiliation": "N",
            "address_1": "3600 Gaston Ave",
            "address_2": "Wadley 550",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.