Amy Rose Benenson, MSPAS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5717 Issued in CT

Practice address

289 Windham Rd
Willimantic, CT 06226-3528

Phone

(860) 343-0302

NPI assigned

Jun 15, 2022

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: amy.benenson@xdr.hhchealthdirect.org

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.

• Rushford Center, Inc.

  • Psychologist
  • Meriden, CT
  • NPI 1275541005
  Medicare reassignment
• Stonington Behavioral Health Inc

  • Psychiatric Hospital
  • North Stonington, CT
  • NPI 1225097231
  NPD (past)

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1427788009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 FIELDSTONE",
            "city": "LEDYARD",
            "state": "CT",
            "postal_code": "063391250",
            "telephone_number": "516-304-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 WINDHAM RD",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263528",
            "telephone_number": "860-343-0302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Swantown Hill Rd",
            "address_purpose": "LOCATION",
            "city": "North Stonington",
            "state": "CT",
            "postal_code": "063591022",
            "country_code": "US",
            "telephone_number": "800-832-1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENENSON",
        "first_name": "AMY",
        "middle_name": "ROSE",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "5717",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "RI",
            "license": "PA01468",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA01468",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Bartelli
• Amy Bartlett, R.PH.
• Nicole Ann Bashar, RDH
• Burton T Bates
• Tyler C Beckwith
• Tara Bergeron, LMSW
• William Bergmann
• Gary L Berman, D.M.D.
• Susie Bernado, NP
• Lori Bernier, LCSW

• Medical Physician Assistant in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.