Michael Benitz

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

RT30125187 Issued in WA

Practice address

2807 W Washington Ave Ste 117
Yakima, WA 98903-1367

Phone

(509) 972-8617

NPI assigned

Jun 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Fastex Advanced Mobile Imaging

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Yakima, WA
  • NPI 1801869383
  NPD Authorized official
• Fastex Advanced Mobile Imaging

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Yakima, WA
  • NPI 1275535247
  NPD
• Fred Thysell MD

  • Family Medicine Physician
  • Yakima, WA
  • NPI 1255805628
  NPD (past)

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1669033601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8051",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989080051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 W WASHINGTON AVE STE 117",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989031367",
            "telephone_number": "509-972-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITZ",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-20",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "WA",
            "license": "RT30125187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell James Benefield, PHARMD
• Jessica Benegas, PHARMD
• Ebelia Benitez
• Ismerai Benitez, CG60662276
• Josefa Erica Benitez, MEDICAL ASSISTANT
• Lisa Benoit, ARNP
• Darian Benskin
• Brandi Berg, ARNP
• Nicole Berg
• Britta Lynn Bergan, MA MHC

• Radiologic Technologist in Yakima, WA
• Providers in Yakima, WA by specialty
• Radiologic Technologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.