Andrew Leon Bennett, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD217581 Issued in OR

Practice address

896 Fortner St
Ontario, OR 97914-1787

Phone

(541) 881-2828

Fax

(541) 881-2880

NPI assigned

Oct 21, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.bennett.1@21291.direct.athenahealth.com
• Direct secure messaging: abennett660794@direct.ochin.org
• Direct secure messaging: abennett2638597@direct.trinity-health.org

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.

• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, OR
  • NPI 1295415032

  OR

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  ID

  Medicare reassignment NPD
• Valley Family Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Payette, ID
  • NPI 1407886484

  Family Medicine, ID

  Medicare reassignment NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Emmett, ID
  • NPI 1932139995

  Family Medicine

  NPD
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Nyssa, OR
  • NPI 1083641310

  Family Medicine

  NPD (past)
• Valley Family Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ontario, OR
  • NPI 1992732291

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1588036396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 10TH AVE",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836615420",
            "telephone_number": "208-642-9376",
            "fax_number": "208-642-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 FORTNER ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979141787",
            "telephone_number": "541-881-2828",
            "fax_number": "541-881-2880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5102 Howard Ln",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836878659",
            "country_code": "US",
            "telephone_number": "208-467-3509",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Kudjip Station, Okuk Highway",
            "address_purpose": "LOCATION",
            "city": "Kudjip",
            "state": "Jiwaka",
            "postal_code": "281",
            "country_code": "PG",
            "telephone_number": "67572161498",
            "country_name": "Papua New Guinea",
            "address_type": "FGN"
        },
        {
            "address_1": "1510 12th Ave Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836866008",
            "country_code": "US",
            "telephone_number": "208-302-6800",
            "fax_number": "208-302-6855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANDREW",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00028532",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-14113",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD217581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Alan Bean, MD
• Anthony Michael Stewart Becerra
• Zoe Araye Bell
• Robin B Belt
• Naghma Benjamin
• Jessica Lynn Berdine, MA, CCC-SLP
• Heather Bergstrom, LCSW
• Matea Berria
• Laura Ashley Besonson, QMHP
• Mindy Anne Best, C-CHW

• All providers in Ontario, OR
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.