Individual provider Active NPI

Cynthia Joanne Benedicktus

  • Acute Care Nurse Practitioner
  • Irvine, CA
National Provider Identifier
1558077263
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95024136 Issued in CA
Practice address
13 Hawthorn
Irvine, CA 92612-2331
Phone
(310) 803-7233
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 761324 CA
Acute Care Nurse Practitioner 363LA2100X 95024136 CA Primary

Addresses

Primary practice location

13 Hawthorn
Irvine, CA 92612-2331

Mailing address

13 Hawthorn
Irvine, CA 92612-2331
Phone (310) 803-7233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829000700 CA Practitioner - Nurse Practitioner 2062875750 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
761324CAMDCritical Care Medicine Registered Nurse
95024136CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of California, Inc CurrentSince Jul 17, 2023 Accepting new patients

Locations

4002 Vista Way
Oceanside, CA 92056
Phone (760) 724-8411

Interoperability endpoints

  • Direct secure messaging: cbenedicktus1145968@direct.llu.edu

Organizations & group practices 1

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": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1558077263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 HAWTHORN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122331",
            "telephone_number": "310-803-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 HAWTHORN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122331",
            "telephone_number": "310-803-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICKTUS",
        "first_name": "CYNTHIA",
        "middle_name": "JOANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "761324",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95024136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.