Individual provider Active NPI

Brian Benenati

  • General Practice Physician
  • Canton, MI
National Provider Identifier
1750065033
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301516257 Issued in MI
Practice address
8542 N Canton Center Rd
Canton, MI 48187-1310
Phone
(734) 455-8310
NPI assigned
Jun 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301516257 MI Primary

Addresses

Primary practice location

8542 N Canton Center Rd
Canton, MI 48187-1310

Mailing address

410 Village Green Blvd Apt 203
Ann Arbor, MI 48105-3613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20260605000956 MI Practitioner - Emergency Medicine 5092173906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Georgetown University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11 Hardenburgh Ave
DeMarest, NJ 07627-1923

15001 Kercheval Ave
Grosse Pointe Park, MI 48230-1361

410 Village Green Blvd
Apt 203
Ann Arbor, MI 48105-3613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4301516257MIMDGeneral Practice Physician

Organizations & group practices 1

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1750065033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 VILLAGE GREEN BLVD APT 203",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481053613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8542 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871310",
            "telephone_number": "734-455-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENENATI",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301516257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.