Individual provider Active NPI

Jeremy Bennett, M.D.

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1518120252
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A112564 Issued in CA
Practice address
3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone
(805) 652-6228
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A112564 CA Primary

Addresses

Primary practice location

3291 Loma Vista Rd
Ventura, CA 93003-3099

Mailing address

3291 Loma Vista Rd
Ventura, CA 93003-3099
Phone (805) 652-6228

Other practice location 1

3270 W Lake St
Minneapolis, MN 55416-4512
Phone (612) 775-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeremy.bennett@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110907000965 CA Practitioner - Family Practice 4981874625 Reassigns benefits to 2 organizations
I20190819002833 MN Practitioner - Family Practice 4981874625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

18465 Orchard TRL
Lakeville, MN 55044-8885
Phone (952) 428-0950

3270 W Lake St
Minneapolis, MN 55416-4512
Phone (612) 775-1800

4166 Lexington Ave N
Shoreview, MN 55126-6106
Phone (651) 241-1306

4194 Lexington Ave N
Shoreview, MN 55126-6106
Phone (651) 483-5461

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Jun 1, 2022 Accepting new patients
Sansum Clinic CurrentSince Feb 1, 2015 Accepting new patients
Allina Health System CurrentSince Jun 1, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Family Medicine CurrentSince Dec 31, 2022 Accepting new patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Feb 1, 2015 Accepting new patients
County of Ventura Current Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

3270 W Lake St
Minneapolis, MN 55416
Phone (612) 775-1800

Interoperability endpoints

  • Direct secure messaging: jeremy.bennett@ventura.cernerdirect.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1518120252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-652-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033099",
            "telephone_number": "805-652-6228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3270 W Lake St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554164512",
            "country_code": "US",
            "telephone_number": "612-775-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JEREMY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A112564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeremy.bennett@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3291 Loma Vista Rd",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930033099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.