Richard Oliver Bennett, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

23-014569 Issued in NY

Practice address

2 Ellis CT
Coram, NY 11727-1473

Phone

(917) 837-8213

NPI assigned

Jan 16, 2011

Last updated

May 24, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1295136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495584000000",
    "number": "1669777009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067952",
            "telephone_number": "631-328-5560",
            "fax_number": "631-328-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ELLIS CT",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271473",
            "telephone_number": "917-837-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RICHARD",
        "middle_name": "OLIVER",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-16",
        "last_updated": "2017-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "23-014569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayada Home Health Care
• Lawrence Stuart Beck, D.C.
• Susan Neel Gilleeny Behrens, D.P.T.
• Nikki Beirne
• Elizabeth Ratnamala Benjamin, NURSE PRACTIONER
• Sammy Eli Benyamin, DPT
• Sweta Bhatt
• Charles L. Billera, D.D.S.
• Justine Biscardi
• James Bloodgood, RPH

• Medical Physician Assistant in Coram, NY
• Providers in Coram, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.