Michael C Bennick, M.D..

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

029125 Issued in CT

Practice address

40 Temple St
Suite 4a
New Haven, CT 06510-2715

Phone

(203) 777-0304

Fax

(203) 401-4687

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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.

• Yale University

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236

  CT

  Medicare reassignment NPD
• Yale University

  • Adult Mental Health Clinic/Center
  • Hamden, CT
  • NPI 1134391824
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD
• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138

  Gastroenterology

  NPD (past)
• Saint Raphael Healthcare System Affiliated Physicians Inc

  • Neurology Physician
  • New Haven, CT
  • NPI 1063744001
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in CT

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbennick@cgc1052.srs-direct.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 2, 2012.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1720129034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST",
            "address_2": "SUITE 4A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-777-0304",
            "fax_number": "203-401-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 TEMPLE ST",
            "address_2": "SUITE 4A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102715",
            "telephone_number": "203-777-0304",
            "fax_number": "203-401-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNICK",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "M.D..",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "029125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001291252",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy E Benjamin, PA
• Harvey Bennett, MD
• Jasmiry D Bennett, DNP, APRN, ACNP-BC,
• Stephanie Amber Bennett
• Jennifer Bennick, APRN
• Cynthia Nunes Benoit, LCSW
• Laelia Naomi Benoit, MD, PHD
• Jessica Lynn Benson, LPC
• Lester Bentley, MS
• Amine Benyakoub, M.D.

• All providers in New Haven, CT
• Gastroenterology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.