Individual provider Active NPI

David Joseph Benes, O.D.

  • Optometrist
  • Bangor, ME
National Provider Identifier
1487768453
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT888 Issued in ME
Practice address
1 Ridgewood Dr
Bangor, ME 04401-2652
Phone
(207) 945-6200
NPI assigned
Aug 18, 2006
Last updated
Apr 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT888 ME Primary

Addresses

Primary practice location

1 Ridgewood Dr
Bangor, ME 04401-2652

Mailing address

935 County Route 61
Shushan, NY 12873-3207
Phone (518) 854-7778

Other identifiers 1

IdentifierTypeStateIssuer
1487768453MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070928000006 ME Practitioner - Optometry 5799763850 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT888MEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care of Maine LLC Optometrist CurrentSince May 23, 2016 Accepting new patients
Vision Care of Maine Aroostook, LLC Optometrist CurrentSince May 23, 2016 Accepting new patients
Vision Care of Maine LLC CurrentSince May 23, 2016 Accepting new patients
Vision Care of Maine-Aroostook LLC Optometrist CurrentSince May 23, 2016 Accepting new patients
Bay Optical, Inc Past Accepting new patients
Eye Care Associates, PC PastSince Jan 1, 2007 Accepting new patients
Kennebec Eyecare PA Optometrist PastSince Jun 20, 2005 Accepting new patients
Luxottica Retail North America Inc Past Accepting new patients

Locations

254 Western Ave
Augusta, ME 04330
Phone (204) 945-6200

1 Ridgewood Dr
Bangor, ME 04401
Phone (207) 667-9690

173 Academy St
Presque Isle, ME 04769
Phone (207) 764-0376

216 Main St
Waterville, ME 04901
Phone (207) 872-2793

Interoperability endpoints

  • Direct secure messaging: david.benesod.p1@direct.visioncareofmaine.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1487768453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 COUNTY ROUTE 61",
            "city": "SHUSHAN",
            "state": "NY",
            "postal_code": "128733207",
            "telephone_number": "518-854-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-945-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENES",
        "first_name": "DAVID",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487768453",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.