Individual provider Active NPI

Michael J Bentley Jr.

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1760842355
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109390 Issued in FL
Practice address
6775 Crosswinds Dr N
St Petersburg, FL 33710-5471
Phone
(727) 381-8006
Fax
(727) 381-9629
NPI assigned
Feb 25, 2016
Last updated
Feb 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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 PA9109390 FL Primary

Addresses

Primary practice location

6775 Crosswinds Dr N
St Petersburg, FL 33710-5471

Mailing address

6775 Crosswinds Dr N
St Petersburg, FL 33710-5471
Phone (727) 381-8006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200427000451 NY Practitioner - Physician Assistant 5991096968 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

158 Orchard St
Rochester, NY 14611-1361
Phone (585) 368-4500

55 Genesee St
Rochester, NY 14611-3201
Phone (585) 368-3506

65 Genesee St
Rochester, NY 14611-3201
Phone (585) 368-3531

75 Genesee St
FL 2
Rochester, NY 14611-3201
Phone (585) 368-3380

89 Genesee St
Rochester, NY 14611-3201
Phone (585) 723-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024625NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Medical Practice P.C. CurrentSince Feb 27, 2024 Accepting new patients
Rochester General Hospital Physician Assistant CurrentSince Feb 27, 2024 Accepting new patients
Western New York Medical Practice PC CurrentSince Feb 27, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Feb 27, 2024 Accepting new patients
United Memorial Medical Center CurrentSince Feb 27, 2024 Accepting new patients
United Memorial Medical Center CurrentSince Feb 27, 2024 Accepting new patients

Locations

16 Bank St
Batavia, NY 14020
Phone (585) 344-4800

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

Organizations & group practices 8

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1760842355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6775 CROSSWINDS DR N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105471",
            "telephone_number": "727-381-8006",
            "fax_number": "727-381-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6775 CROSSWINDS DR N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105471",
            "telephone_number": "727-381-8006",
            "fax_number": "727-381-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-25",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.