Individual provider Active NPI

Nelson V Benjers, M.D.

  • Specialist
  • Clinton, MD
National Provider Identifier
1629069968
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D00028281 Issued in MD
Practice address
9131 Piscataway Rd
Suite 600
Clinton, MD 20735-2508
Phone
(301) 868-0110
Fax
(301) 856-0604
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D00028281 MD Primary

Addresses

Primary practice location

9131 Piscataway Rd
Suite 600
Clinton, MD 20735-2508

Mailing address

9131 Piscataway Rd
Suite 600
Clinton, MD 20735-2508
Phone (301) 868-0110

Other identifiers 3

IdentifierTypeStateIssuer
1734OtherMDBC/BS MD
3104-0001OtherDCBC/BS DC
37590-1600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20101028000543 DC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6901090570

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D00028281MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Management Associates Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1629069968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY RD",
            "address_2": "SUITE 600",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352508",
            "telephone_number": "301-868-0110",
            "fax_number": "301-856-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY RD",
            "address_2": "SUITE 600",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352508",
            "telephone_number": "301-868-0110",
            "fax_number": "301-856-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJERS",
        "first_name": "NELSON",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D00028281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS MD",
            "identifier": "1734",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS DC",
            "identifier": "3104-0001",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37590-1600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.