Individual provider Active NPI

Maria Teresa Datan Benitez, M.D.

  • Obstetrics & Gynecology Physician
  • Palm Springs, CA
National Provider Identifier
1700044187
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
C55826 Issued in CA
Practice address
1100 N Palm Canyon Dr
Suite 212
Palm Springs, CA 92262-4414
Phone
(760) 327-7900
Fax
(760) 327-7905
NPI assigned
Jun 2, 2008
Last updated
May 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X C55826 CA Primary
Obstetrics & Gynecology Physician 207V00000X 4301092193 MI

Addresses

Primary practice location

1100 N Palm Canyon Dr
Suite 212
Palm Springs, CA 92262-4414

Mailing address

1100 N Palm Canyon Dr
Suite 212
Palm Springs, CA 92262-4414
Phone (760) 327-7900

Other identifiers 4

IdentifierTypeStateIssuer
GR0101242MedicaidCA
ZZZ27958ZOtherCAMEDICARE GROUP ID
GR0101241MedicaidCA
GR0101240MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20140418000065 CA Practitioner - Obstetrics/Gynecology 0143395350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1180 N Indian Canyon Dr
Suite W300
Palm Springs, CA 92262-4809
Phone (760) 327-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C55826CAMDObstetrics & Gynecology Physician
4301092193MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Women's Healthcare, a Medical Corporation Obstetrics & Gynecology CurrentSince Feb 9, 2014 Accepting new patients
Advanced Women's Healthcare, a Medical Corporation Obstetrics & Gynecology Current Accepting new patients
Great Lakes Bay Health Centers Obstetrics & Gynecology Past Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Great Lakes Bay Health Centers Past Accepting new patients
Advanced Women's Healthcare, a Medical Corporation Obstetrics & Gynecology Past Accepting new patients
Eisenhower Medical Center Past Accepting new patients
McLaren Bay Region Past Accepting new patients

Locations

79200 Corporate Center Dr
Ste 201
La Quinta, CA 92253
Phone (760) 222-5502

41990 Cook St
Bldg H
Palm Desert, CA 92211

1100 N Palm Canyon Dr
Ste 212
Palm Springs, CA 92262

1180 N Indian Canyon Dr
Ste W300
Palm Springs, CA 92262
Phone (760) 416-3770

7355 Church St
Ste F
Yucca Valley, CA 92284

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: maria.teresa.benitez.1@23413.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23413/brand/1/csg/1/fhir/r4

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1700044187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR",
            "address_2": "SUITE 212",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624414",
            "telephone_number": "760-327-7900",
            "fax_number": "760-327-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N PALM CANYON DR",
            "address_2": "SUITE 212",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624414",
            "telephone_number": "760-327-7900",
            "fax_number": "760-327-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENITEZ",
        "first_name": "MARIA TERESA",
        "middle_name": "DATAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C55826",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301092193",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101242",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "ZZZ27958Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101241",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

Verify at the official NPI Registry.