Individual provider Active NPI

Benoit C Pineau, MD

  • Gastroenterology Physician
  • St Augustine, FL
National Provider Identifier
1619173309
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME90376 Issued in FL
Practice address
100 Whetstone Place
Suite 105
St. Augustine, FL 32086
Phone
(904) 829-9557
Fax
(904) 829-9125
NPI assigned
Jun 21, 2007
Last updated
May 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME90376 FL Primary

Addresses

Primary practice location

100 Whetstone Place
Suite 105
St. Augustine, FL 32086

Mailing address

4800 Belfort Road
Jacksonville, FL 32256
Phone (904) 398-3262

Other identifiers 2

IdentifierTypeStateIssuer
269931100MedicaidFL
44069OtherFLBCBS OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040806000108 FL Practitioner - Gastroenterology 2769453232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy196
Upper gastrointestinal (GI) endoscopy for acid reflux400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90376FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Borland Groover Clinic, PA Gastroenterology CurrentSince Nov 1, 2008 Accepting new patients
Gastroenterology Associates of St Augustine, PA Gastroenterology Past Accepting new patients
First Coast Gastroenterology Gastroenterology PastSince Aug 15, 2004 Accepting new patients

Locations

836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

100 Whetstone Pl
Ste 105
St Augustine, FL 32086
Phone (904) 824-3777

40 Groover Loop
Ste 200
St Augustine, FL 32086
Phone (904) 824-6108

Interoperability endpoints

  • Direct secure messaging: ben.pineau.p1@direct.bgclinic.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: bpineau743289@direct.shands.ufl.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 3

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1619173309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT ROAD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-398-3262",
            "fax_number": "904-265-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WHETSTONE PLACE",
            "address_2": "SUITE 105",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-829-9557",
            "fax_number": "904-829-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEAU",
        "first_name": "BENOIT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME90376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269931100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "44069",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.