Individual provider Active NPI

Michael Painter Benedict, PHARMD

  • Pharmacist
  • Tempe, AZ
National Provider Identifier
1740834654
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S023459 Issued in AZ
Practice address
1275 W Washington St Ste 105
Tempe, AZ 85281-1859
Phone
(480) 240-1111
Fax
(480) 240-1112
NPI assigned
Jul 29, 2019
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S023459 AZ Primary

Addresses

Primary practice location

1275 W Washington St Ste 105
Tempe, AZ 85281-1859

Mailing address

1580 N Fiesta Blvd Ste 103
Gilbert, AZ 85233-1032
Phone (480) 253-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S023459AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Op Pharmacy LLC CurrentSince Oct 17, 2021 Accepting new patients
BNR Healthcare Corp PastSince Aug 1, 2019 Accepting new patients
BNR Healthcare Corp PastSince Aug 1, 2019 Accepting new patients

Locations

1275 W Washington St
Ste 105
Tempe, AZ 85288
Phone (480) 240-1111

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1740834654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 N FIESTA BLVD STE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331032",
            "telephone_number": "480-253-3100",
            "fax_number": "866-663-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 W WASHINGTON ST STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852811859",
            "telephone_number": "480-240-1111",
            "fax_number": "480-240-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "MICHAEL",
        "middle_name": "PAINTER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2021-10-13",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S023459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.