Individual provider Active NPI

Benjamin Dao Dao, M.D.

  • Interventional Cardiology Physician
  • Henderson, NC
National Provider Identifier
1548624059
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
202301783 Issued in NC
Practice address
511 Ruin Creek Rd Ste 106
Henderson, NC 27536-5919
Phone
(522) 572-4223
Fax
(252) 572-4150
NPI assigned
Apr 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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
Interventional Cardiology Physician 207RI0011X 202301783 NC Primary

Addresses

Primary practice location

511 Ruin Creek Rd Ste 106
Henderson, NC 27536-5919

Mailing address

PO Box 725
Cooperstown, NY 13326-0725
Phone (607) 547-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230922001423 NC Practitioner - Cardiovascular Disease (Cardiology) 6002102431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champion Health System, PAGroup PAC ID 2769774694, 5 clinicians

Practice addresses (Care Compare)

511 Ruin Creek Rd
Suite 106
Henderson, NC 27536-5919
Phone (252) 572-4223

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Varicose vein removal26
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202301783NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Health System, PA Cardiovascular Disease CurrentSince Sep 1, 2023 Accepting new patients
Champion Heart and Vascular Center, Oxford PLLC Cardiovascular Disease PastSince May 1, 2020 Accepting new patients

Locations

710 Erwin Rd
Dunn, NC 28334
Phone (910) 304-1212

721 Tilghman Dr
Ste 400
Dunn, NC 28334
Phone (910) 292-2070

511 Ruin Creek Rd
Ste 106
Henderson, NC 27536
Phone (252) 436-6571

1614 Williamsboro St
Oxford, NC 27565
Phone (252) 572-4223

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 5

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1548624059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 725",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133260725",
            "telephone_number": "607-547-3456",
            "fax_number": "607-547-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD STE 106",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "522-572-4223",
            "fax_number": "252-572-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAO",
        "first_name": "BENJAMIN",
        "middle_name": "DAO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "202301783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

Verify at the official NPI Registry.