Individual provider Active NPI

Benny Esquenazi, MD

  • Obstetrics & Gynecology Physician
  • Pembroke Pines, FL
National Provider Identifier
1417970377
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME96081 Issued in FL
Practice address
10067 Pines Blvd
B
Pembroke Pines, FL 33024-6136
Phone
(954) 430-7777
Fax
(954) 430-3667
NPI assigned
Jul 25, 2006
Last updated
May 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME96081 FL Primary

Addresses

Primary practice location

10067 Pines Blvd
B
Pembroke Pines, FL 33024-6136

Mailing address

10067 Pines Blvd
B
Pembroke Pines, FL 33024-6136
Phone (954) 430-7777

Other identifiers 6

IdentifierTypeStateIssuer
349455OtherFLWELLCARE
SG082351OtherFLVISTA
5404821OtherFLCIGNA
349455OtherFLSTAYWELL
276488100MedicaidFL
349455OtherFLHEALTHEASE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070504000412 FL Practitioner - Obstetrics/Gynecology 3274639497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

601 N Flamingo Rd
203 Advanced Female Care LLC
Pembroke Pines, FL 33028-1008
Phone (954) 607-3811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME96081FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Aug 1, 2009 Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

601 N Flamingo Rd
Ste 203
Pembroke Pines, FL 33028
Phone (954) 392-7770

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEEBCA/Endpoint/FEEBCA

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1417970377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10067 PINES BLVD",
            "address_2": "B",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246136",
            "telephone_number": "954-430-7777",
            "fax_number": "954-430-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10067 PINES BLVD",
            "address_2": "B",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246136",
            "telephone_number": "954-430-7777",
            "fax_number": "954-430-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUENAZI",
        "first_name": "BENNY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME96081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "349455",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISTA",
            "identifier": "SG082351",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5404821",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL",
            "identifier": "349455",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276488100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHEASE",
            "identifier": "349455",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.