Active NPI
Mark Paul Benjamin, OPTOMETRIST OD DEGRE
- Vision Therapy Optometrist
- Merrillville, IN
National Provider Identifier
1669599403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vision Therapy Optometrist
- License
- 18002462B
- Practice address
- 759 East 81St Avenue
Merrillville, IN 46410 - Phone
- (219) 736-0013
- Fax
- (219) 769-8842
- NPI assigned
- Mar 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002462A | IN | |
| Vision Therapy Optometrist | 152WV0400X | 18002462B | IN | Primary |
Addresses
Primary practice location
759 East 81St Avenue
Merrillville, IN 46410
Mailing address
823 West 89TH Place
Merrillville, IN 46410
Phone (219) 795-1356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18002462A | IN | MD | Optometrist |
| 18002462B | IN | MD | Vision Therapy Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1669599403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "823 WEST 89TH PLACE",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "46410",
"telephone_number": "219-795-1356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 EAST 81ST AVENUE",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "46410",
"telephone_number": "219-736-0013",
"fax_number": "219-769-8842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENJAMIN",
"first_name": "MARK",
"middle_name": "PAUL",
"credential": "OPTOMETRIST OD DEGRE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002462A",
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "IN",
"license": "18002462B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.