Benacare Medical Center, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A6396 Issued in CA

Legal business name

BENACARE MEDICAL CENTER, INC

Practice address

984 W Foothill Blvd
Upland, CA 91786-3700

Phone

(909) 373-8222

Fax

(877) 803-0308

NPI assigned

Jan 22, 2007

Last updated

Apr 2, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melinda Benavidez

Title

Administrator

Phone

(909) 373-8222

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Anthony Benavidez, D.O.

  • Family Medicine Physician
  • Upland, CA
  • NPI 1205987914
  Medicare reassignment NPD
• Gisella Victoria Olivares, D.O.

  • Family Medicine Physician
  • Pomona, CA
  • NPI 1821138405
  Medicare reassignment NPD
• Jennifer Rose Boozer, DO

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1417067299
  NPD (past)

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1427101369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863700",
            "telephone_number": "909-373-8222",
            "fax_number": "877-803-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863700",
            "telephone_number": "909-373-8222",
            "fax_number": "877-803-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENACARE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "BENAVIDEZ",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-373-8222"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A6396",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8664",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX63960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Bekendam, M.D.
• Peter D Bekendam, MD
• Alix Louise Bell
• Allison Leigh Bell, FNP-C
• Ma Alyssa Maye P. Bello
• Michael Anthony Benavidez, D.O.
• Cecil Mayra Benitez, M.D., PH.D.
• Jeannette Benjamin, M.D.
• Jessika Benjamin, O.D.
• Shyanne Lynn Benjamin

• Family Medicine Physician in Upland, CA
• Providers in Upland, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.