Kelly Benabou, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

287530 Issued in MA

Practice address

3300 Main Street
4TH FL, Suite D
Springfield, MA 01107-1112

Phone

(413) 794-7045

Fax

(413) 794-7345

NPI assigned

Jun 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Obstetrics/Gynecology

Education

University of Pittsburgh School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baystate Medical Center Hospital, Springfield, MA, CCN 220077

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Baystate Medical Practices, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Springfield, MA
  • NPI 1548205909

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Baystate Medical Center, Inc.

  dba Baystate Pharmacy

  • Community/Retail Pharmacy
  • Springfield, MA
  • NPI 1881799427
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baystate Medical Center Inc

  dba Baystate Medical Center

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1487655064
  Care Compare affiliation
• Baystate Medical Center Inc

  dba Baystate Reference Laboratories

  • Clinical Medical Laboratory
  • Springfield, MA
  • NPI 1568488450

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1558743864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT STREET",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN STREET",
            "address_2": "4TH FL, SUITE D",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-7045",
            "fax_number": "413-794-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENABOU",
        "first_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "62422",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "287530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myosoti Kyshaelis Bello Irizarry
• Monica Lee Bellucci
• Luis Beltran
• Bemore Wellness, LLC
• Shaza Ben Khadra, MD
• Mark K Benander, PH.D., M.S.
• Tatiana V Bendioukova, MD
• Beneath the Healing LLC
• Amie Benedict
• Janet A Beneitone, R.N.

• Obstetrics & Gynecology Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Obstetrics & Gynecology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.