Individual provider Active NPI

Juan Benitez, MD

  • Gastroenterology Physician
  • Knoxville, TN
National Provider Identifier
1699752105
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
37313 Issued in TN
Practice address
9330 Park West Blvd Ste 506
Knoxville, TN 37923-4313
Phone
(865) 539-5372
Fax
(865) 539-5369
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 37313 TN Primary

Addresses

Primary practice location

9330 Park West Blvd Ste 506
Knoxville, TN 37923-4313

Mailing address

9330 Park West Blvd Ste 506
Knoxville, TN 37923-4313
Phone (865) 539-5372

Other identifiers 2

IdentifierTypeStateIssuer
Q022507MedicaidTN
3883441MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Benitez.juan@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20041007000565 TN Practitioner - Gastroenterology 7214913201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

9330 Park W Blvd
Suite 402
Knoxville, TN 37923-4312
Phone (865) 890-3003

Hospital & facility affiliations

  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
  • Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

Merit-based Incentive Payment System (MIPS)

Final score
37.79 of 100Reported as individual
Quality
26.67
Improvement activities
0
Cost
90.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy396
Upper gastrointestinal (GI) endoscopy for acid reflux264

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37313TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Gastrointestinal Specialists PLLC Specialist CurrentSince Aug 1, 2004 Accepting new patients
Covenant Medical Group, Inc CurrentSince Dec 1, 2024 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Dunes Optical, LLC Past Accepting new patients
Medical Group Surgery Center LLC Past Accepting new patients

Locations

9330 Park West Blvd
Ste 402
Knoxville, TN 37923
Phone (865) 690-3003

9330 Park West Blvd
Ste 506
Knoxville, TN 37923
Phone (865) 539-2020

Dept 888179
Knoxville, TN 37995

576 Fort Loudon Medical Center Dr
Ste 105
Lenoir City, TN 37772
Phone (865) 539-5372

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Interoperability endpoints

  • Direct secure messaging: benitez.juan@covenanthealth.cernerdirect.com

Organizations & group practices 5

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 3

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1699752105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD STE 506",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234313",
            "telephone_number": "865-539-5372",
            "fax_number": "865-539-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD STE 506",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234313",
            "telephone_number": "865-539-5372",
            "fax_number": "865-539-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "JUAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "37313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022507",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3883441",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Benitez.juan@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9330 Park West Blvd Ste 506",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.