Bruce A Benkley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

588-023 Issued in WI

Practice address

1328 US Highway 2
Crystal Falls, MI 49920-1045

Phone

(906) 875-4486

NPI assigned

Jun 2, 2006

Last updated

Feb 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1437196896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W ICE LAKE RD",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "499359526",
            "telephone_number": "906-265-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 US HIGHWAY 2",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201045",
            "telephone_number": "906-875-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENKLEY",
        "first_name": "BRUCE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "588-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970028874",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42931900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "970028873",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437196896",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aspirus Iron River Hospital & Clinics, Inc. (Aspirus Crystal Falls Clinic)
• Aspirus Iron River Hospital & Clinics, Inc. (Aspirus Dialysis - Crystal Falls)
• Richard L Beaudoin, PT, DPT
• Bellin Memorial Hospital Inc (Bellin Health Heart & Vascular Crystal Falls)
• Kim Bjork
• Lisa Anne Carollo, MS,OTL
• Crystal Chiropractic, P.C.
• Cube Imaging PLC
• Lisa Jean Curnow, O.T.R.

• Physician Assistant in Crystal Falls, MI
• Providers in Crystal Falls, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.