NPIMap

Individual provider Active NPI

Sabrina Ann Benjamin, MD

  • Internal Medicine Physician
  • Olympia, WA
National Provider Identifier
1447280334
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00025146 Issued in WA
Practice address
1340 Allegheny Court SE
Suite 304
Olympia, WA 98503
Phone
(360) 701-2554
Fax
(360) 438-1297
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00025146 WA Primary

Addresses

Primary practice location

1340 Allegheny Court SE
Suite 304
Olympia, WA 98503

Mailing address

PO Box 8339
Lacey, WA 98509-8339
Phone (360) 701-2554

Other identifiers 3

IdentifierTypeStateIssuer
1097732MedicaidWA
107299OtherWADEPT. L & I
MD00025146OtherWAWA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000633 WA Practitioner - Internal Medicine 5496898686 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00025146WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin Medical PLLC Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients
Fox Medical Center PastSince Jun 27, 2021 Accepting new patients
Lowers Holdings LLC Past Accepting new patients
BD Olympia I, LLC Past Accepting new patients
Heartwood Operator LLC Past Accepting new patients
BD Tacoma I, LLC Past Accepting new patients
Tacoma Rehab, LLC Past Accepting new patients
Munoz Regimbal and Associates Physicians Professional LLC Past Accepting new patients
Highland Wellnesscare, LLC PastSince Nov 20, 2020 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tacoma Nursing and Rehabilitation CenterTacoma, WA, CCN 505154 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 20, 2020
Nov 20, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1447280334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8339",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985098339",
            "telephone_number": "360-701-2554",
            "fax_number": "360-438-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 ALLEGHENY COURT SE",
            "address_2": "SUITE 304",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98503",
            "telephone_number": "360-701-2554",
            "fax_number": "360-438-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "SABRINA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00025146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1097732",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. L & I",
            "identifier": "107299",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "MD00025146",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.