Individual provider Active NPI

Benjamin R Veenstra, M.D.

  • Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1427286822
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME157958 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jun 24, 2009
Last updated
Sep 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125055921 IL
Surgery Physician 208600000X ME157958 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

1653 W Congress Pkwy
Rush
Chicago, IL 60612-3833
Phone (312) 942-5000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bveenstra@direct.ccprovider.org Direct Cook County
Direct Messaging Address bveenstra1985423@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140816000295 FL Practitioner - General Surgery 4688891534 Reassigns benefits to 1 organization
I20150622000190 IL Practitioner - General Surgery 4688891534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tulane University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy14
Hernia repair - groin (open)12
Hernia repair (minimally invasive)46
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125055921ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Surgery CurrentSince Oct 22, 2019 Accepting new patients
Cook County Current Accepting new patients
Cook County Surgery CurrentSince Jul 19, 2016 Accepting new patients
Cook County CurrentSince Jul 19, 2016 Accepting new patients

Locations

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 810
Chicago, IL 60612
Phone (312) 942-6500

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (630) 724-1300

Interoperability endpoints

  • Direct secure messaging: bveenstra@direct.ccprovider.org
  • Direct secure messaging: bveenstra12343@direct.rush.rush-health.com

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 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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1427286822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1653 W Congress Pkwy",
            "address_2": "RUSH",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123833",
            "country_code": "US",
            "telephone_number": "312-942-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEENSTRA",
        "first_name": "BENJAMIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125055921",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME157958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bveenstra@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bveenstra1985423@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.