Individual provider Active NPI

Benjamin C Damico

  • Physical Therapist
  • Surprise, AZ
National Provider Identifier
1609365188
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
13995 W Statler Blvd Ste 165
Surprise, AZ 85374-5501
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
May 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

13995 W Statler Blvd Ste 165
Surprise, AZ 85374-5501

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180706000495 AZ Practitioner - Physical Therapist in Private Practice 8123374063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13995 W Statler Blvd
Suite 165
Surprise, AZ 85374-5517
Phone (866) 974-2673

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as group
Quality
76.23
Promoting interoperability
100
Improvement activities
40
Cost
75.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Educatoin Physical Therapist CurrentSince Jun 6, 2018 Accepting new patients
Center for Orthopedic Research and Education LLC CurrentSince Jun 6, 2018 Accepting new patients
Center for Orthopedic Research and Education, LLC Physical Therapist Current Accepting new patients

Locations

1840 N Jasper Dr
Ste 3
Flagstaff, AZ 86001

2680 S Val Vista Dr
Bldg 9
Gilbert, AZ 85295
Phone (480) 269-7504

2680 S Val Vista Dr
Ste 146
Gilbert, AZ 85295
Phone (480) 454-7680

3420 S Mercy Rd
Ste 200
Gilbert, AZ 85297
Phone (480) 909-3788

1500 S Dobson Rd
Ste 201
Mesa, AZ 85202
Phone (623) 537-5661

1450 S Dobson Rd
Ste A302
Mesa, AZ 85202
Phone (480) 461-1334

1500 S Dobson Rd
Ste 201D
Mesa, AZ 85202

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

9305 W Thomas Rd
Ste 275
Phoenix, AZ 85037
Phone (623) 327-4144

9321 W Thomas Rd
Ste 305
Phoenix, AZ 85037

18444 N 25th Ave
Ste 220
Phoenix, AZ 85023
Phone (669) 742-6738

8952 E Desert Cove Ave
Ste 113
Scottsdale, AZ 85260
Phone (480) 314-7772

10484 W Thunderbird Blvd
Ste 100
Sun City, AZ 85351
Phone (669) 742-6738

10503 W Thunderbird Blvd
Ste 262
Sun City, AZ 85351
Phone (623) 832-5589

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

13995 W Statler Blvd
Ste 165
Surprise, AZ 85374
Phone (623) 537-5661

13995 W Statler Blvd
Surprise, AZ 85374
Phone (623) 478-3100

Interoperability endpoints

  • Direct secure messaging: benjamin.damico.1@22724.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1609365188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 W STATLER BLVD STE 165",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745501",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "BENJAMIN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.