Individual provider Active NPI

Mathew Benjamin, M.D.

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1699891614
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29241 Issued in AZ
Practice address
605 N Gilbert Rd
Mesa, AZ 85203-6629
Phone
(480) 398-1220
Fax
(480) 398-1230
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29241 AZ Primary

Addresses

Primary practice location

605 N Gilbert Rd
Mesa, AZ 85203-6629

Mailing address

605 N Gilbert Rd
Mesa, AZ 85203-6629
Phone (480) 398-1220

Other identifiers 1

IdentifierTypeStateIssuer
711368MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040510000330 AZ Practitioner - Internal Medicine 7911996517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenician Medical Center IncGroup PAC ID 0547169708, 36 clinicians

Practice addresses (Care Compare)

1343 N Alma School Rd
Suite 205
Chandler, AZ 85224-5903
Phone (480) 963-1853

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29241AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenician Medical Center, Inc Internal Medicine CurrentSince Sep 7, 2020 Accepting new patients
Shannon Gray Past Accepting new patients
Platinum Internal Medicine Internal Medicine Past Accepting new patients
VMG, LLC Past Accepting new patients

Locations

1343 N Alma School Rd
Ste 205
Chandler, AZ 85224
Phone (480) 722-2588

1343 N Alma School Rd
Chandler, AZ 85224
Phone (623) 572-4545

1343 N Alma School Rd
Ste 160
Chandler, AZ 85224
Phone (480) 444-7447

13620 N Saguaro Blvd
Ste 100
Fountain Hls, AZ 85268
Phone (480) 816-3130

16515 S 40th St
Ste 139
Phoenix, AZ 85048
Phone (480) 706-0174

Organizations & group practices 4

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 1

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1699891614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N GILBERT RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036629",
            "telephone_number": "480-398-1220",
            "fax_number": "480-398-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N GILBERT RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036629",
            "telephone_number": "480-398-1220",
            "fax_number": "480-398-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "MATHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "29241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "711368",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.