Makeba Lacheryl Benjamin

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95034214 Issued in CA

Practice address

10310 Vaughn Dr
Stockton, CA 95212-9344

Phone

(209) 981-9551

NPI assigned

Apr 24, 2025

Last updated

Apr 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hospitalists of Modesto Medical Group Inc

  • Internal Medicine Physician
  • Modesto, CA
  • NPI 1821190711
  Medicare reassignment NPD

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1568259109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10310 VAUGHN DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952129344",
            "telephone_number": "209-981-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10310 VAUGHN DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952129344",
            "telephone_number": "209-981-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "MAKEBA",
        "middle_name": "LACHERYL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95034214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Beninati
• Amanda Marie Benitez
• Felecia Benitez
• Ricardo J Benitez
• Richard Anthony Benitez, MHC I
• David Jay Benkle, O.D.
• Calvin Ray Bennet, SUDRC
• Candice Lee Bennett
• Dejon M Bennett
• Hannah Kaylee Bennett

• Nurse Practitioner in Stockton, CA
• Providers in Stockton, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.

Verify at the official NPI Registry.