Individual provider Active NPI

Susan Kaye Benner, MPT

  • Physical Therapist
  • Laguna Niguel, CA
National Provider Identifier
1649415712
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23874 Issued in CA
Practice address
31341 Niguel Rd
Suite G
Laguna Niguel, CA 92677-4118
Phone
(949) 234-9720
Fax
(949) 234-9722
NPI assigned
Dec 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23874 CA Primary

Addresses

Primary practice location

31341 Niguel Rd
Suite G
Laguna Niguel, CA 92677-4118

Mailing address

31341 Niguel Rd
Suite G
Laguna Niguel, CA 92677-4118
Phone (949) 234-9720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23874CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Gillman M D Inc PastSince Oct 20, 2010 Accepting new patients
Deborah Weinstein Physical Therapy Physical Therapist PastSince Oct 30, 2011 Accepting new patients

Organizations & group practices 2

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": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1649415712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31341 NIGUEL RD",
            "address_2": "SUITE G",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774118",
            "telephone_number": "949-234-9720",
            "fax_number": "949-234-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31341 NIGUEL RD",
            "address_2": "SUITE G",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926774118",
            "telephone_number": "949-234-9720",
            "fax_number": "949-234-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNER",
        "first_name": "SUSAN",
        "middle_name": "KAYE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "23874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.