Ryan E. Bentley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301500471 Issued in MI

Practice address

400 136TH Ave Ste 416
Holland, MI 49424-2905

Phone

(616) 294-3211

Fax

(714) 362-9011

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 5, 2021 through Jan 5, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1669482139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DRIVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 136TH AVE STE 416",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242905",
            "telephone_number": "616-294-3211",
            "fax_number": "714-362-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W Paterson St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072557",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "RYAN",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301500471",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002056",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin H. Wickstra DDS, PLLC
• Benjamin'S Hope
• Benjamin'S Hope
• Tracy Bennett, LBSW
• Kristopher Greyson Bentel
• Mark Daniel Berard, DDS
• Lee Edwards Berens, M.D.
• Farah N Berent, PA
• Martin C Berent, MD
• Anthony Peter Berger, MD

• Family Medicine Physician in Holland, MI
• Providers in Holland, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.