Individual provider Active NPI

Karen Benik, M.D.

  • Dermatology Physician
  • Lake Forest, CA
National Provider Identifier
1447226386
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G60765 Issued in CA
Practice address
23832 Rockfield Blvd Ste 210
Lake Forest, CA 92630-2876
Phone
(949) 770-8115
Fax
(949) 770-2017
NPI assigned
Feb 28, 2006
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G60765 CA Primary

Addresses

Primary practice location

23832 Rockfield Blvd Ste 210
Lake Forest, CA 92630-2876

Mailing address

23832 Rockfield Blvd Ste 210
Lake Forest, CA 92630-2876
Phone (949) 770-8115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001434 CA Practitioner - PodiatryPractitioner - Dermatology 3072639947

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G60765CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Tang, M.D., Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

23832 Rockfield Blvd
Ste 210
Lake Forest, CA 92630
Phone (949) 770-8115

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1447226386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 210",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302876",
            "telephone_number": "949-770-8115",
            "fax_number": "949-770-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23832 ROCKFIELD BLVD STE 210",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302876",
            "telephone_number": "949-770-8115",
            "fax_number": "949-770-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENIK",
        "first_name": "KAREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G60765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.