Individual provider Active NPI

Benjamin Carl Smith

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Dallas, TX
National Provider Identifier
1619266772
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
P7987 Issued in TX
Practice address
12201 Merit Dr Ste 450
Dallas, TX 75251-3127
Phone
(972) 532-3024
Fax
(972) 532-3189
NPI assigned
Mar 29, 2011
Last updated
Sep 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VF0040X P7987 TX Primary

Addresses

Primary practice location

12201 Merit Dr Ste 450
Dallas, TX 75251-3127

Mailing address

12201 Merit Dr Ste 450
Dallas, TX 75251-3127
Phone (972) 532-3024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180911002996 TX Practitioner - Obstetrics/Gynecology 3870843964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Mercer University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

12201 Merit Dr
Suite 450
Dallas, TX 75251-3127
Phone (972) 532-3024

3500 Gaston Ave
Dallas, TX 75246-2017
Phone (214) 820-2139

6700 Buenos Aires Dr
N Richland Hills, TX 76180-6566
Phone (817) 281-8245

920 Santa Fe Dr
Suite 103
Weatherford, TX 76086-5865
Phone (817) 339-8855

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P7987TXMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Single Specialty Current Accepting new patients
Texas Health Care, P.L.L.C. Single Specialty CurrentSince Jan 7, 2020 Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Jan 7, 2020 Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

12201 Merit Dr
Ste 450
Dallas, TX 75251
Phone (972) 532-3024

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

920 Santa Fe Dr
Ste 103
Weatherford, TX 76086
Phone (817) 339-8855

Interoperability endpoints

  • Direct secure messaging: benjamin.smith.2@8042.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1619266772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 MERIT DR STE 450",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513127",
            "telephone_number": "972-532-3024",
            "fax_number": "972-532-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 MERIT DR STE 450",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513127",
            "telephone_number": "972-532-3024",
            "fax_number": "972-532-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BENJAMIN",
        "middle_name": "CARL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-29",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "TX",
            "license": "P7987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.