Individual provider Active NPI

Zachary Ernest Benson, M.D.

  • Hematology & Oncology Physician
  • Boise, ID
National Provider Identifier
1740677954
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
M-16595 Issued in ID
Practice address
190 E Bannock St
Boise, ID 83712
Phone
(208) 381-2222
NPI assigned
Apr 26, 2015
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M-16595 ID
Internal Medicine Physician 207R00000X 0101264372 VA
Hematology & Oncology Physician 207RH0003X M-16595 ID Primary

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712

Mailing address

100 E Idaho St
Boise, ID 83712-6241
Phone (208) 381-2711

Other practice location 1

1250 E Marshall St
Richmond, VA 23298-5051
Phone (804) 828-8786

Other practice location 2

417 N 11th St
Richmond, VA 23298
Phone (804) 828-8786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, ID2 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
I20180911003237 VA Practitioner - Internal Medicine 0446564264 Reassigns benefits to 1 organization
I20220707002409 ID Practitioner - Internal Medicine 0446564264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nevada School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

100 E Idaho St
Suite 200
Boise, ID 83712-6270
Phone (208) 381-2222

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101264372VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jun 23, 2022 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Jun 23, 2022 Accepting new patients
Vibra Physicians LLC CurrentSince Mar 20, 2019 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

5 E River Park Pl E
Ste 460
Fresno, CA 93720

100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223

100 E Idaho St
Ste 200
Boise, ID 83712
Phone (208) 381-7312

100 E Idaho St
Ste 210
Boise, ID 83712

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

8081 Royal Ridge Pkwy
Ste 130
Irving, TX 75063
Phone (844) 870-6689

2220 Edward Holland Dr
Richmond, VA 23230
Phone (804) 678-7000

Organizations & group practices 4

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 7

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": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1740677954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2711",
            "fax_number": "208-381-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-381-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-8786",
            "fax_number": "804-828-5466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "417 N 11th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "23298",
            "country_code": "US",
            "telephone_number": "804-828-8786",
            "fax_number": "804-828-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENSON",
        "first_name": "ZACHARY",
        "middle_name": "ERNEST",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-26",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-16595",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101264372",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "ID",
            "license": "M-16595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.