Individual provider Active NPI

Benjamin Nathan Massat

  • Hematology & Oncology Physician
  • Maywood, IL
National Provider Identifier
1659909711
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036165424 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(888) 584-7888
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036165424 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (888) 584-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20200901000099 WI Order and Referring Only - General SurgeryPractitioner - General Surgery 3072930403

Care Compare profile

Medicare Care Compare
Specialty
Hematology
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036165424ILMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1659909711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "888-584-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "888-584-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSAT",
        "first_name": "BENJAMIN",
        "middle_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036165424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.