Individual provider Active NPI

Benjamin Brian Williamson, MD

  • Psychiatry Physician
  • Newport Beach, CA
National Provider Identifier
1467730093
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A162939 Issued in CA
Practice address
4100 Newport Place Dr Ste 730
Newport Beach, CA 92660-1411
Phone
(714) 705-6410
Fax
(714) 705-6411
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A162939 CA Primary

Addresses

Primary practice location

4100 Newport Place Dr Ste 730
Newport Beach, CA 92660-1411

Mailing address

4100 Newport Place Dr Ste 730
Newport Beach, CA 92660-1411

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702000431 CA Practitioner - Psychiatry 5698198042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wayne State University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1503 S Coast Dr
Suite 111
Costa Mesa, CA 92626-1526
Phone (844) 867-8444

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A162939CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Health Solutions a Professional Medical Corporation Psychiatry CurrentSince Mar 31, 2020 Accepting new patients

Locations

1503 S Coast Dr
Ste 111
Costa Mesa, CA 92626
Phone (714) 206-6868

5455 Wilshire Blvd
Ste 903
Los Angeles, CA 90036
Phone (628) 244-4364

4100 Newport Place Dr
Ste 730
Newport Beach, CA 92660
Phone (714) 705-6411

360 Post St
Ste 500
San Francisco, CA 94108
Phone (415) 671-6819

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1467730093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 NEWPORT PLACE DR STE 730",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 NEWPORT PLACE DR STE 730",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601411",
            "telephone_number": "714-705-6410",
            "fax_number": "714-705-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "BENJAMIN",
        "middle_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-01",
        "last_updated": "2025-08-05",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A162939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.