NPIMap

Individual provider Active NPI

Benjamin Tetsu Lish, M.D.

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1417901067
Registry record updated Dec 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A67012 Issued in CA
Practice address
120 N Ashwood Ave
Ventura, CA 93003-1810
Phone
(805) 658-5800
Fax
(805) 639-0786
NPI assigned
May 19, 2006
Last updated
Dec 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2013

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 A67012 CA Primary

Addresses

Primary practice location

120 N Ashwood Ave
Ventura, CA 93003-1810

Mailing address

5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801

Other identifiers 6

IdentifierTypeStateIssuer
RHM08609FMedicaidCA
ZZT40394FMedicaidCA
RHM08608FMedicaidCA
RHM18553HMedicaidCA
050394OtherCABLUE CROSS
95-1683892OtherCAOTHER INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040428000671 CA Practitioner - Family Practice 0547257982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

120 N Ashwood Ave
Ventura, CA 93003-1810
Phone (805) 658-5800

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

2921 Saviers Rd
Oxnard, CA 93033-5314
Phone (805) 487-5588

321 E Port Hueneme Rd
Port Hueneme, CA 93041-3222
Phone (805) 652-4267

3641 W 5TH St
Oxnard, CA 93030-6424
Phone (805) 985-5505

3655 W 5TH St
Oxnard, CA 93030-6424
Phone (805) 948-4442

422 Arneill Rd B
Camarillo, CA 93010-6434
Phone (805) 383-4510

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A67012CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Jan 1, 2005 Accepting new patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Jan 1, 2005 Accepting new patients
Community Memorial Health System Past Accepting new patients
Coastal Communities Physician Network, Inc. Past Accepting new patients
Bakersfield Family Medical Group Inc Family Medicine Past Accepting new patients
Community Memorial Health System Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients

Locations

5800 Santa Rosa Rd
Ste 149
Camarillo, CA 93012
Phone (805) 465-8900

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

852 W Ventura St
Fillmore, CA 93015
Phone (805) 524-2672

655 Ventura Ave
Oak View, CA 93022
Phone (805) 649-3750

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

3641 W 5th St
Oxnard, CA 93030
Phone (805) 985-5505

250 Citrus Grove Ln
Ste 150
Oxnard, CA 93036
Phone (805) 981-3770

2361 E Vineyard Ave
Oxnard, CA 93036
Phone (805) 981-3770

258 E Harvard Blvd
Santa Paula, CA 93060
Phone (805) 525-5518

242 E Harvard Blvd
Ste C
Santa Paula, CA 93060
Phone (805) 525-9595

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

2705 Loma Vista Rd
Ste 206
Ventura, CA 93003
Phone (805) 643-4067

120 N Ashwood Ave
Ventura, CA 93003
Phone (805) 658-5800

168 N Brent St
Ste 302
Ventura, CA 93003
Phone (805) 652-6373

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: blish3518222@oc.providencedirect.org
  • Direct secure messaging: benjaminlish@cfh.allscriptsdirect.net

Organizations & group practices 8

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388016000000",
    "number": "1417901067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801",
            "fax_number": "805-667-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N ASHWOOD AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031810",
            "telephone_number": "805-658-5800",
            "fax_number": "805-639-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISH",
        "first_name": "BENJAMIN",
        "middle_name": "TETSU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A67012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08609F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT40394F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM08608F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RHM18553H",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050394",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER INSURANCE",
            "identifier": "95-1683892",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.