NPIMap

Individual provider Active NPI

Manjunath B Benakanahalli, MD

  • Internal Medicine Physician
  • Brandon, FL
National Provider Identifier
1619067428
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME97496 Issued in FL
Practice address
603 W Lumsden Rd
Brandon, FL 33511-5911
Phone
(813) 435-3912
Fax
(813) 655-3913
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME97496 FL Primary

Addresses

Primary practice location

603 W Lumsden Rd
Brandon, FL 33511-5911

Mailing address

603 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 435-3912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071208000162 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5890884100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

603 W Lumsden Rd
Brandon, FL 33511-5911
Phone (813) 435-3912

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Benakanahalli MD PA Internal Medicine CurrentSince Nov 11, 2009 Accepting new patients

Locations

603 W Lumsden Rd
Brandon, FL 33511
Phone (813) 435-3912

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CAIECA/Endpoint/CAIECA

Organizations & group practices 1

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1619067428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-435-3912",
            "fax_number": "813-655-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 W LUMSDEN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115911",
            "telephone_number": "813-435-3912",
            "fax_number": "813-655-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAKANAHALLI",
        "first_name": "MANJUNATH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME97496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.