NPIMap

Individual provider Active NPI

Benigno B Bobon, M.D.

  • Internal Medicine Physician
  • Duluth, GA
National Provider Identifier
1487645032
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
034303 Issued in GA
Practice address
3505 Duluth Park LN
Building 4, Ste 400
Duluth, GA 30096-3201
Phone
(678) 597-3180
Fax
(678) 597-3181
NPI assigned
Nov 2, 2005
Last updated
Jun 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 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 034303 GA Primary

Addresses

Primary practice location

3505 Duluth Park LN
Building 4, Ste 400
Duluth, GA 30096-3201

Mailing address

3505 Duluth Park LN
Building 4, Ste 400
Duluth, GA 30096-3201
Phone (678) 597-3180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20060130000068 GA Practitioner - Internal Medicine 3274547252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maxa Internal Medicine Associates PCGroup PAC ID 7113831017, 6 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

3505 Duluth Park Lane
BLDG 4 Suite 400
Duluth, GA 30096

3505 Duluth Park LN
Suite 400
Duluth, GA 30096-3203
Phone (678) 597-3180

3680 Pleasant Hill Rd
Suite 101
Duluth, GA 30096-3268
Phone (770) 813-5575

901 Haymon Morris Rd
Winder, GA 30680-7837
Phone (678) 705-2123

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.6 of 100Reported as group
Quality
100
Improvement activities
40
Cost
75.32

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maxa Internal Medicine Associates PC CurrentSince Nov 7, 2005 Accepting new patients
Northside Primary Care Professional Services, LLC Past Accepting new patients

Locations

3505 Duluth Park Ln
Ste 400
Duluth, GA 30096
Phone (678) 579-3180

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACEDBA

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1487645032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 DULUTH PARK LN",
            "address_2": "BUILDING 4, STE 400",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963201",
            "telephone_number": "678-597-3180",
            "fax_number": "678-597-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 DULUTH PARK LN",
            "address_2": "BUILDING 4, STE 400",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300963201",
            "telephone_number": "678-597-3180",
            "fax_number": "678-597-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBON",
        "first_name": "BENIGNO",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "034303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.