Individual provider Active NPI

Brian K Benjamin, MD

  • Pediatrics Physician
  • Noblesville, IN
National Provider Identifier
1649236902
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01061299A Issued in IN
Practice address
865 Westfield Rd Ste B
Noblesville, IN 46062-8901
Phone
(317) 776-0880
NPI assigned
Apr 25, 2006
Last updated
May 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01061299A IN Primary

Addresses

Primary practice location

865 Westfield Rd Ste B
Noblesville, IN 46062-8901

Mailing address

865 Westfield Rd Ste B
Noblesville, IN 46062-8938

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brian.benjamin.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20130906000509 IN Practitioner - Pediatric Medicine 2163665381 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061299AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. Pediatrics CurrentSince Jan 1, 2019 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

865 Westfield Rd
Noblesville, IN 46062
Phone (317) 770-1700

865 Westfield Rd
Ste B
Westfield, IN 46062
Phone (317) 776-0880

Interoperability endpoints

  • Direct secure messaging: brian.benjamin.1@7598.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1649236902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 WESTFIELD RD STE B",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460628938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 WESTFIELD RD STE B",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460628901",
            "telephone_number": "317-776-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01061299A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brian.benjamin.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "865 Westfield Rd Ste B",
            "city": "Noblesville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460628901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Noblesville, IN

Sources for this page

Verify at the official NPI Registry.