Individual provider Active NPI

Benjamin C. Dickert, DPM

  • Podiatrist
  • Springfield, MA
National Provider Identifier
1760599815
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PD1884 Issued in MA
Practice address
222 Carew St
Ste 101
Springfield, MA 01104-4105
Phone
(413) 736-3225
Fax
(413) 736-3382
NPI assigned
Aug 24, 2006
Last updated
May 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PD1884 MA Primary

Addresses

Primary practice location

222 Carew St
Ste 101
Springfield, MA 01104-4105

Mailing address

222 Carew St
Ste 101
Springfield, MA 01104-4105
Phone (413) 736-3225

Other identifiers 2

IdentifierTypeStateIssuer
0362663MedicaidMA
0774440001OtherMAMEDICARE DMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060417000147 MA Practitioner - Podiatry 3779557889 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, MA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benjamin C DickertGroup PAC ID 2062486178, 2 clinicians

Practice addresses (Care Compare)

222 Carew St
Suite 101
Springfield, MA 01104-4105
Phone (413) 736-3225

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue32
Removal of nail tissue1018
Removal or shaving of skin growth165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PD1884MAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology & Imaging Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: benjamin.dickert.1@32847.direct.athenahealth.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1760599815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 CAREW ST",
            "address_2": "STE 101",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011044105",
            "telephone_number": "413-736-3225",
            "fax_number": "413-736-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CAREW ST",
            "address_2": "STE 101",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011044105",
            "telephone_number": "413-736-3225",
            "fax_number": "413-736-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERT",
        "first_name": "BENJAMIN",
        "middle_name": "C.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "PD1884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0362663",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "0774440001",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.