Individual provider Active NPI

Amy Benedict, PA-C

  • Physician Assistant
  • Wyoming, MI
National Provider Identifier
1760660633
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002370 Issued in MI
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

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
Center for Vein Restoration Mi PLLCGroup PAC ID 5092998294, 10 clinicians

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 100Reported as group
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. Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1873TNMDOptometrist
5601002370MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Restoration Mi PLLC CurrentSince Mar 28, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.