Individual provider Active NPI

Jon W Benner, MD

  • Surgery Physician
  • Monterey, CA
National Provider Identifier
1649241886
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G41631 Issued in CA
Practice address
2 Upper Ragsdale Dr
B230
Monterey, CA 93940-5736
Phone
(831) 649-1000
NPI assigned
Jan 27, 2006
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G41631 CA Primary

Addresses

Primary practice location

2 Upper Ragsdale Dr
B230
Monterey, CA 93940-5736

Mailing address

2 Upper Ragsdale Dr
Ste B230
Monterey, CA 93940-7853
Phone (831) 649-0808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060213000717 CA Practitioner - Vascular SurgeryPractitioner - General Surgery 3870551153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Southern California Keck School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montage Medical GroupGroup PAC ID 6406901941, 125 clinicians

Practice addresses (Care Compare)

2 Upper Ragsdale Dr
BLDG a
Monterey, CA 93940-5736
Phone (831) 718-9701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.59 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
73.46

Merit-based Incentive Payment System (MIPS)

Final score
96.06 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
88.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)16
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G41631CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Oct 1, 2007 Accepting new patients
Montage Medical Group CurrentSince Aug 1, 2023 Accepting new patients
Community Hospital of the Monterey Peninsula Past Accepting new patients

Locations

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

2 Upper Ragsdale Dr
Bldg A
Monterey, CA 93940
Phone (831) 333-3040

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

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 2

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1649241886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UPPER RAGSDALE DR",
            "address_2": "STE B230",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407853",
            "telephone_number": "831-649-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UPPER RAGSDALE DR",
            "address_2": "B230",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405736",
            "telephone_number": "831-649-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "JON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G41631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.