Robert Bennett, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

54216 Issued in CA

Practice address

100 Wilshire Blvd Ste 700
Santa Monica, CA 90401-3602

Phone

(310) 419-8799

NPI assigned

Dec 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1467995803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILSHIRE BLVD STE 700",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904013602",
            "telephone_number": "310-419-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILSHIRE BLVD STE 700",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904013602",
            "telephone_number": "310-419-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-01",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9110133",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "54216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel S Bennahum
• Bennett Surgery Centers a Medical Corp
• Emma Bennett, M.S.W., LCSW #79627
• Jazmin Bennett, MSN, RN, FNP-BC
• Richard Gary Bennett, MD
• Ryan Everett Bennett, M.D.
• Susanne M Bennett, DC
• Kimberly Sandra Benning, LMFT
• Samia Bennis
• Kendall Benson

• Medical Physician Assistant in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.