Individual provider Active NPI

Alyn L Benezette, D.O.

  • Neurology Physician
  • Ormond Beach, FL
National Provider Identifier
1508863572
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OS5774 Issued in FL
Practice address
725 W Granada Blvd
Suite 22
Ormond Beach, FL 32174-9406
Phone
(386) 788-2300
Fax
(386) 944-6622
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X OS5774 FL Primary

Addresses

Primary practice location

725 W Granada Blvd
Suite 22
Ormond Beach, FL 32174-9406

Mailing address

725 W Granada Blvd
Suite 22
Ormond Beach, FL 32174-9406
Phone (386) 788-2300

Other identifiers 1

IdentifierTypeStateIssuer
117752200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080814000638 FL Practitioner - NeurologyPractitioner - Interventional Pain Management 4880588177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Interventional Pain Management
Education
Michigan State University College of Osteopathic Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Neurology IncGroup PAC ID 4082669478, 9 clinicians

Practice addresses (Care Compare)

725 W Granada Blvd
Suite 22
Ormond Beach, FL 32174-9406
Phone (386) 788-2300

Hospital & facility affiliations

  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS5774FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Neurology, Inc. Neurology CurrentSince Aug 21, 2009 Accepting new patients
Ormond Aligned Chiropractic, LLC PastSince Nov 10, 2024 Accepting new patients
Medical Diagnostic Clinics Inc Past Accepting new patients
VRT Healthcare Centers Inc Past Accepting new patients
Lombardo Chiropractic Clinic PA PastSince Jun 12, 2017 Accepting new patients

Locations

760 S Volusia Ave
Ste 400
Orange City, FL 32763
Phone (386) 774-0220

725 W Granada Blvd
Ste 22
Ormond Beach, FL 32174
Phone (386) 274-0097

801 Beville Rd
Ste 202
South Daytona, FL 32119
Phone (800) 723-9668

801 Beville Rd
South Daytona, FL 32119
Phone (352) 213-4295

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1508863572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 W GRANADA BLVD",
            "address_2": "SUITE 22",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749406",
            "telephone_number": "386-788-2300",
            "fax_number": "386-944-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W GRANADA BLVD",
            "address_2": "SUITE 22",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749406",
            "telephone_number": "386-788-2300",
            "fax_number": "386-944-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEZETTE",
        "first_name": "ALYN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2025-06-16",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "OS5774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117752200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.