Marty Neal Bennett, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

L0029 Issued in TX

Practice address

16479 Dallas Pkwy Ste 320
Addison, TX 75001-6709

Phone

(469) 484-4260

Fax

(469) 484-4265

NPI assigned

Apr 5, 2006

Last updated

Apr 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Psychiatry

Education

University of North Carolina at Chapel Hill School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Preston Hollow Psychiatry Group, PLLC

  • Psychiatry Physician
  • Addison, TX
  • NPI 1851583397
  Medicare reassignment NPD Authorized official
• Dallas Center for Advanced Depression Treatments

  • Adult Mental Health Clinic/Center
  • Addison, TX
  • NPI 1710566773
  NPD Authorized official
• Kip Queenan MD, PLLC

  • Psychiatry Physician
  • Addison, TX
  • NPI 1619160603
  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1487616272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16479 DALLAS PKWY STE 320",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016709",
            "telephone_number": "469-484-4260",
            "fax_number": "469-484-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16479 DALLAS PKWY STE 320",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016709",
            "telephone_number": "469-484-4260",
            "fax_number": "469-484-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARTY",
        "middle_name": "NEAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L0029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151750001",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "secure messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct communication",
            "address_1": "16479 Dallas Pkwy Ste 320",
            "city": "Addison",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750016709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Jill Bebout, APRN
• Breck Beckner
• Kevin Bedford, DPT
• Derrick Javier Belan, DPT
• Anna Cecelia Belou
• Alexander Stephen Berk, JD, M.ED., LPC
• Racheal Ebangha Besong, RN
• Jessica Betran
• Russell Arthur Betts, ATC, LAT
• Krista Marie Bey, MS CCC-SLP

• Psychiatry Physician in Addison, TX
• Providers in Addison, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.