Jason L. Vanbennekom, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME93647 Issued in FL

Practice address

400 Colonnade Dr Ste 230
Ponte Vedra, FL 32081-6237

Phone

(904) 640-8249

Fax

(904) 640-8250

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Obstetrics/Gynecology

Education

University of Michigan Medical School, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.vanbennekom@wcfnf.eclinicaldirectplus.com
• FHIR API: https://api.platform.athenahealth.com/25889/brand/1/csg/1/fhir/r4

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.

• Women'S Care Florida LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1013902923
  Medicare reassignment Care Compare group NPD
• Womens' Health Hospitalists, LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1205295599
  Medicare reassignment NPD
• Women'S Care Florida LLC

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
  • NPI 1568045573
  NPD (past)
• Premier Aesthetics

  • Dermatology Physician
  • Danville, VA
  • NPI 1134862311
  NPD (past)

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

• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1720040983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 COLONNADE DR STE 230",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816237",
            "telephone_number": "904-640-8249",
            "fax_number": "904-640-8250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14546 Old Saint Augustine Rd Ste 305&311",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322585468",
            "country_code": "US",
            "telephone_number": "904-260-2255",
            "fax_number": "904-260-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBENNEKOM",
        "first_name": "JASON",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME93647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273136300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Updike
• Upscale Ultrasound & Mobile 3D 4D, LLC
• Urgent Care Cure LLC
• Valley Ridge Pediatric Dentistry
• Annette Strickland Van Horn, PSY.D.
• Daisamma Varghese, NP
• Kristi Pelletier Vega, LMFT
• Fatima Camangian Vergara, ARNP, MSN-FNP
• Lori Vespia, D.M.D.
• Christina Marie Vogel, RPH

• Obstetrics & Gynecology Physician in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.