Individual provider Active NPI

Benjamin Isaac Mwanika, DO

  • Sports Medicine (Family Medicine) Physician
  • Harrisonburg, VA
National Provider Identifier
1457595258
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
0102203559 Issued in VA
Practice address
2509 Pleasant Run Dr
Harrisonburg, VA 22801-8720
Phone
(540) 689-5500
Fax
(540) 757-7574
NPI assigned
Apr 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X T9755 TX
Sports Medicine (Family Medicine) Physician 207QS0010X 0102203559 VA Primary
Family Medicine Physician 207Q00000X T9755 TX

Addresses

Primary practice location

2509 Pleasant Run Dr
Harrisonburg, VA 22801-8720

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other practice location 1

25553 Highway 59
Porter, TX 77365-6154
Phone (713) 442-2100

Other practice location 2

106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone (713) 442-1800

Other practice location 3

8233 N Sam Houston Pkwy E
Humble, TX 77396-2922
Phone (713) 442-2000

Other identifiers 1

IdentifierTypeStateIssuer
1457595258MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TX2 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
I20130826000424 VA Practitioner - Sports Medicine 3375713027 Reassigns benefits to 1 organization
I20221128000710 TX Practitioner - Sports MedicinePractitioner - Family Practice 3375713027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

106 Vision Park Blvd
Shenandoah, TX 77384-3000
Phone (713) 442-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T9755TXMDFamily Medicine Physician
0102203559VAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Family Medicine CurrentSince Jan 9, 2023 Accepting new patients
RMH Medical Group LLC CurrentSince Jan 1, 2016 Accepting new patients
RMH Medical Group LLC CurrentSince Jan 1, 2016 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

8503 N Sam Houston Pkwy E
Humble, TX 77396
Phone (346) 674-3500

8233 N Sam Houston Pkwy E
Humble, TX 77396
Phone (713) 442-2000

201 Enterprise Ave
Ste 900
League City, TX 77573
Phone (713) 442-2826

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

25553 Highway 59
Porter, TX 77365
Phone (713) 442-2100

106 Vision Park Blvd
Shenandoah, TX 77384
Phone (713) 442-1800

1931 Medical Ave
Harrisonburg, VA 22801
Phone (540) 564-5400

136 W Elizabeth St
Ste 201
Harrisonburg, VA 22802
Phone (540) 564-5104

2509 Pleasant Run Dr
Rockingham, VA 22801
Phone (540) 689-4500

2010 Health Campus Dr
Rockingham, VA 22801
Phone (540) 689-1000

Interoperability endpoints

  • Direct secure messaging: bmwanika48017@direct.kelsey-seybold.com

Organizations & group practices 4

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1457595258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 PLEASANT RUN DR",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228018720",
            "telephone_number": "540-689-5500",
            "fax_number": "540-757-7574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25553 Highway 59",
            "address_purpose": "LOCATION",
            "city": "Porter",
            "state": "TX",
            "postal_code": "773656154",
            "country_code": "US",
            "telephone_number": "713-442-2100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Vision Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Shenandoah",
            "state": "TX",
            "postal_code": "773843000",
            "country_code": "US",
            "telephone_number": "713-442-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8233 N Sam Houston Pkwy E",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773962922",
            "country_code": "US",
            "telephone_number": "713-442-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MWANIKA",
        "first_name": "BENJAMIN",
        "middle_name": "ISAAC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "T9755",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102203559",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T9755",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457595258",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.