Individual provider Active NPI

Gregory Benenati

  • Physician Assistant
  • Dix Hills, NY
National Provider Identifier
1669127593
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3 Beatrice CT
Dix Hills, NY 11746-5302
Phone
(631) 827-7172
NPI assigned
Feb 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3 Beatrice CT
Dix Hills, NY 11746-5302

Mailing address

3 Beatrice CT
Dix Hills, NY 11746-5302
Phone (631) 827-7172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230518002376 NY Practitioner - Physician Assistant 2466818349 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028178NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 9, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Feb 9, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1669127593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BEATRICE CT",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465302",
            "telephone_number": "631-827-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BEATRICE CT",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465302",
            "telephone_number": "631-827-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENENATI",
        "first_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.