NPIMap

Individual provider Active NPI

Benoit Dube, MD

  • Psychiatry Physician
  • Philadelphia, PA
National Provider Identifier
1659307338
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD069674L Issued in PA
Practice address
3535 Market St
3Rd Floor
Philadelphia, PA 19104
Phone
(215) 746-6700
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine Physician 2084P0015X MD069674L PA
Psychiatry Physician 2084P0800X MD069674L PA Primary

Addresses

Primary practice location

3535 Market St
3Rd Floor
Philadelphia, PA 19104

Mailing address

3535 Market Street
3Rd Floor
Philadelphia, PA 19104
Phone (215) 662-2286

Other identifiers 1

IdentifierTypeStateIssuer
0019058240001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100524000495 PA Practitioner - Psychiatry 9638208044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical Group 3,433 clinicians

Practice addresses (Care Compare)

3535 Market St
FL 3
Philadelphia, PA 19104-3317
Phone (215) 746-6700

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD069674LPAMDPsychosomatic Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Psychiatry CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group Current Accepting new patients

Locations

3535 Market St
Fl 3
Philadelphia, PA 19104
Phone (215) 746-6700

3535 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2816

Organizations & group practices 17

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.

View all 17

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1659307338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 MARKET STREET",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 MARKET ST",
            "address_2": "3RD FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-746-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "BENOIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "PA",
            "license": "MD069674L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD069674L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019058240001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.