Individual provider Active NPI

David Roger Benavides, M.D., PH.D.

  • Neurology Physician
  • Baltimore, MD
National Provider Identifier
1609194885
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
D77507 Issued in MD
Practice address
110 S Paca St
3Rd Floor
Baltimore, MD 21201-1642
Phone
(410) 328-5605
Fax
(410) 328-5425
NPI assigned
May 12, 2010
Last updated
Apr 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D77507 MD Primary

Addresses

Primary practice location

110 S Paca St
3Rd Floor
Baltimore, MD 21201-1642

Mailing address

110 S Paca St
3Rd Floor
Baltimore, MD 21201-1642
Phone (410) 328-5605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140920000054 MD Practitioner - Neurology 1052560463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Texas Southwestern Medical School at Dallas, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16 S Eutaw St
Floor 3
Baltimore, MD 21201-1606
Phone (410) 328-4323

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-4323

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 448-6383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Neurology Associates, P.a. CurrentSince Apr 1, 2017 Accepting new patients
University of Maryland Neurology Associates, P.a. Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

Interoperability endpoints

  • Direct secure messaging: dbenavides478180@direct.umm.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1609194885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "3RD FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-5605",
            "fax_number": "410-328-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PACA ST",
            "address_2": "3RD FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011642",
            "telephone_number": "410-328-5605",
            "fax_number": "410-328-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDES",
        "first_name": "DAVID",
        "middle_name": "ROGER",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D77507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.