Individual provider Active NPI

Jeremy Michael Benger, D.O.

  • Anesthesiology Physician
  • Bridgeport, WV
National Provider Identifier
1548422751
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2613 Issued in WV
Practice address
327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone
(681) 342-1000
NPI assigned
Jun 29, 2008
Last updated
Oct 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OT012579 PA
Anesthesiology Physician 207L00000X 2613 WV Primary

Addresses

Primary practice location

327 Medical Park Dr
Bridgeport, WV 26330-9006

Mailing address

PO Box 6209
Wheeling, WV 26003-0714
Phone (304) 233-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20120717000050 WV Practitioner - Anesthesiology 9931365186 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2613WVMDDentist
OT012579PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of West Virginia, PLLC Anesthesiology CurrentSince May 23, 2022 Accepting new patients
Mid-Atlantic Anesthesia Consultants, LLC Anesthesiology Past Accepting new patients

Locations

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

Organizations & group practices 3

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": "1214697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1548422751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6209",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260030714",
            "telephone_number": "304-233-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MEDICAL PARK DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309006",
            "telephone_number": "681-342-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENGER",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-29",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "OT012579",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "2613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.