Individual provider Active NPI

Benjamin Huntley, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1740574144
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P3896 Issued in TX
Practice address
6410 Fannin St Ste 350
Houston, TX 77030-3004
Phone
(832) 325-7131
NPI assigned
Jun 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X P3896 TX
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X DR.0056087 CO
Family Medicine Physician 207Q00000X 503OL33918961 TX
Family Medicine Physician 207Q00000X P3896 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 350
Houston, TX 77030-3004

Mailing address

6410 Fannin St Ste 350
Houston, TX 77030-3004
Phone (832) 325-7131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131119000744 TX Practitioner - Obstetrics/GynecologyPractitioner - Emergency Medicine 4587890637 Reassigns benefits to 1 organization
I20171011002987 CO Practitioner - Family Practice 4587890637 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P3896TXMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
503OL33918961TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica Campesina Family Health Services Multi-Specialty Current Accepting new patients
Clinica Campesina Family Health Services CurrentSince Oct 9, 2017 Accepting new patients
Portercare Adventist Health System Past Accepting new patients
Clinica Campesina Family Health Services Past Accepting new patients
Yukon-Kuskokwim Health Corporation Past Accepting new patients

Locations

2000 W South Boulder Rd
Lafayette, CO 80026
Phone 30366530361250

1735 S Public Rd
Lafayette, CO 80026
Phone 30366530361061

1345 Plaza Ct N
Ste 1A
Lafayette, CO 80026
Phone (303) 665-2962

1735 S Public Rd
Ste 203
Lafayette, CO 80026

8510 Bryant St
Ste 200
Westminster, CO 80031
Phone (303) 449-6050

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/663c4c6d-1396-44a4-b589-c11a968d4876/

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1740574144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 350",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303004",
            "telephone_number": "832-325-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 350",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303004",
            "telephone_number": "832-325-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTLEY",
        "first_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-02",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "TX",
            "license": "P3896",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0056087",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "503OL33918961",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P3896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.