Individual provider Active NPI

John Benjamin, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1679987374
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT206816 Issued in PA
Practice address
245 N. 15TH Street
Philadelphia, PA 19102
Phone
(215) 762-2365
NPI assigned
Jun 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 19383 NV
Emergency Medicine Physician 207P00000X MT206816 PA Primary

Addresses

Primary practice location

245 N. 15TH Street
Philadelphia, PA 19102

Mailing address

131 S 13TH St # 3F
Philadelphia, PA 19107-4903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200122002795 NV Practitioner - Emergency Medicine 2668748716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity-Nevada Medical Services Koury and Partners PCGroup PAC ID 2163968603, 64 clinicians

Practice addresses (Care Compare)

4855 Blue Diamond Rd
Suite 100
Las Vegas, NV 89139-7602
Phone (702) 216-7305

Hospital & facility affiliations

  • Saint Rose Dominican Hospitals - North Las Vegas Hospital, North Las Vegas, NV, CCN 290058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT206816PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Nevada Medical Services Koury & Partners PC Emergency Medicine Current Accepting new patients
Vituity-Nevada Medical Services Koury & Partners PC Emergency Medicine CurrentSince Jul 9, 2024 Accepting new patients
Vituity-Nevada Medical Services Koury & Partners PC Emergency Medicine CurrentSince Jul 9, 2024 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

4980 W Sahara Ave
Ste 100
Las Vegas, NV 89146
Phone (702) 216-7365

4855 Blue Diamond Rd
Ste 100
Las Vegas, NV 89139
Phone (702) 216-7305

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1679987374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 S 13TH ST # 3F",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N. 15TH STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-762-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-20",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "19383",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT206816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.