Active NPI
Amy Benedict, PA-C
- Physician Assistant
- Wyoming, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601002370
- Practice address
- 4124 56TH St SW Ste 2
Wyoming, MI 49418-9494 - Phone
- (616) 224-0120
- NPI assigned
- Feb 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002370 | MI | Primary |
Addresses
Primary practice location
4124 56TH St SW Ste 2
Wyoming, MI 49418-9494
Mailing address
4124 56TH St SW Ste 2
Wyoming, MI 49418-9494
Phone (616) 224-0120
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221129001328 | MI | Practitioner - Physician Assistant | 1456530211 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3810 W Centre Ave a
Portage, MI 49024-4632
Phone (855) 830-8346
4124 56TH St SW
Suite 2
Wyoming, MI 49418-9494
Phone (855) 830-8346
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1873 | TN | MD | Optometrist |
| 5601002370 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Vein Restoration Mi PLLC | Current | Accepting new patients |
Locations
7474 Greenway Center Dr
Ste 1000
Greenbelt, MD 20770
Phone (240) 965-3271
4085 Burton St SE
Ste 101
Grand Rapids, MI 49546
837 Seminole Rd
Ste 204
Norton Shores, MI 49441
3810 W Centre Ave
Ste A
Portage, MI 49024
15255 Northline Rd
Southgate, MI 48195
Phone (734) 285-3090
4124 56th St SW
Ste 2
Wyoming, MI 49418
Phone (616) 241-6380
Interoperability endpoints
- amy.benedictpac.p3@direct.cvr.nextgenshare.com
Organizations & group practices 2
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Midland, MI
- NPI 1225906274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742515200000",
"number": "1760660633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4124 56TH ST SW STE 2",
"city": "WYOMING",
"state": "MI",
"postal_code": "494189494",
"telephone_number": "616-224-0120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4124 56TH ST SW STE 2",
"city": "WYOMING",
"state": "MI",
"postal_code": "494189494",
"telephone_number": "616-224-0120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENEDICT",
"first_name": "AMY",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-04",
"last_updated": "2025-03-21",
"certification_date": "2025-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.