Individual provider Active NPI

Brian Anthony Benenati, M.D.

  • Ophthalmology Physician
  • Detroit, MI
National Provider Identifier
1700373867
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301506694 Issued in MI
Practice address
4717 Saint Antoine St
Detroit, MI 48201-1423
Phone
(313) 577-8900
NPI assigned
Apr 15, 2018
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Ophthalmology Physician 207W00000X 4301506694 MI Primary

Addresses

Primary practice location

4717 Saint Antoine St
Detroit, MI 48201-1423

Mailing address

37196 Camellia LN
Clinton Township, MI 48036-2016
Phone (586) 226-0902

Other practice location 1

1101 W University Dr
Rochester, MI 48307-1863
Phone (248) 601-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220608000568 MI Practitioner - Ophthalmology 9931430204 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastside Eye Physicians PCGroup PAC ID 3678560018, 6 clinicians
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

25511 Little Mack Ave
St. Clair Shores, MI 48081-3300

25511 Little Mack Ave a
Saint Clair Shores, MI 48081-3300

30117 Schoenherr Rd
Suite 400
Warren, MI 48088-6854
Phone (586) 738-9470

47100 Schoenherr Rd F
Shelby Township, MI 48315-4714
Phone (586) 247-2020

4717 Saint Antoine St
Detroit, MI 48201-1423
Phone (313) 577-8900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as group
Quality
89.52
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastside Eye Physicians, PC Ophthalmology CurrentSince Mar 25, 2024 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Ophthalmology CurrentSince Feb 21, 2024 Accepting new patients
University Physician Group Ophthalmology CurrentSince Jul 1, 2022 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Feb 21, 2024 Accepting new patients
University Physician Group Past Accepting new patients
Eastside Eye Physicians, PC Past Accepting new patients
Eastside Eye Physicians, PC Past Accepting new patients

Locations

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4717 Saint Antoine St
Detroit, MI 48201
Phone (313) 577-7614

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

47100 Schoenherr Rd
Ste F
Shelby Township, MI 48315
Phone (586) 247-2020

25511 Little Mack Ave
Ste A
St Clr Shores, MI 48081
Phone (586) 774-2020

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

30117 Schoenherr Rd
Ste 400
Warren, MI 48088
Phone (586) 552-4848

Interoperability endpoints

  • Direct secure messaging: brian.benenati.1@19711.direct.athenahealth.com

Organizations & group practices 7

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.

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": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1700373867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37196 CAMELLIA LN",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362016",
            "telephone_number": "586-226-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011423",
            "telephone_number": "313-577-8900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MI",
            "postal_code": "483071863",
            "country_code": "US",
            "telephone_number": "248-601-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENENATI",
        "first_name": "BRIAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-15",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301506694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.