Active NPI
Nathan Richard Benner, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Portland, ME
National Provider Identifier
1558999474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- MD30218
- Practice address
- 33 Sewall St
Portland, ME 04102-2603 - Phone
- (207) 828-2100
- NPI assigned
- Mar 27, 2020
- Last updated
- Sep 1, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200702001623 | WA | Order and Referring Only - 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.