Individual provider Active NPI

Nathan Richard Benner, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Portland, ME
National Provider Identifier
1558999474
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
MD30218 Issued in ME
Practice address
33 Sewall St
Portland, ME 04102-2603
Phone
(207) 828-2100
NPI assigned
Mar 27, 2020
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD30218 ME Primary

Addresses

Primary practice location

33 Sewall St
Portland, ME 04102-2603

Mailing address

33 Sewall St
Portland, ME 04102-2638
Phone (207) 828-2100

Other practice location 1

14 Thomas Point Rd
Brunswick, ME 04011-3911
Phone (207) 828-2100

Other practice location 2

4 Commons Ave Ste A
Windham, ME 04062-5554
Phone (207) 828-2100

Other practice location 3

22 Station Ave Ste 201
Brunswick, ME 04011-2092
Phone (207) 828-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200702001623 WA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 0446673818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1558999474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022638",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022603",
            "telephone_number": "207-828-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Thomas Point Rd",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040113911",
            "country_code": "US",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4 Commons Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "ME",
            "postal_code": "040625554",
            "country_code": "US",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 Station Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112092",
            "country_code": "US",
            "telephone_number": "207-828-2100",
            "fax_number": "207-553-7166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNER",
        "first_name": "NATHAN",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "ME",
            "license": "MD30218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.