Individual provider Active NPI

Benjamin Michael Gesing, PSYD

  • Clinical Psychologist
  • West Dundee, IL
National Provider Identifier
1669870747
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008934 Issued in IL
Practice address
2474 Knowlton Dr
West Dundee, IL 60118-3530
Phone
(704) 408-8897
NPI assigned
Dec 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.008934 IL Primary

Addresses

Primary practice location

2474 Knowlton Dr
West Dundee, IL 60118-3530

Mailing address

2474 Knowlton Dr
West Dundee, IL 60118-3530
Phone (704) 408-8897

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150331001179 IL Practitioner - Clinical Psychologist 6406173418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Professional Services in Health Psychology, LTDGroup PAC ID 4981736550, 19 clinicians

Practice addresses (Care Compare)

1625 Bethany Rd
Sycamore, IL 60178-3124
Phone (779) 777-7335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.008934ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services in Health Psychology, LTD Clinical CurrentSince Mar 15, 2015 Accepting new patients
Three Birds Mental Health Services PLLC Past Accepting new patients

Locations

2540 Hauser Ross Dr
Ste 225
Sycamore, IL 60178
Phone (815) 758-8400

1625 Bethany Rd
Sycamore, IL 60178
Phone (779) 777-7335

Organizations & group practices 2

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": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1669870747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 KNOWLTON DR",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601183530",
            "telephone_number": "704-408-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 KNOWLTON DR",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601183530",
            "telephone_number": "704-408-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESING",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Dundee, IL

Sources for this page

Verify at the official NPI Registry.