Active NPI
Paul Anson Benjamin
- Psychiatric/Mental Health Nurse Practitioner
- Winter Garden, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 11021024
- Practice address
- 1854 Portcastle Cir
Winter Garden, FL 34787-4747 - Phone
- (786) 877-0503
- NPI assigned
- Aug 1, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11021024 | FL | Primary |
Addresses
Primary practice location
1854 Portcastle Cir
Winter Garden, FL 34787-4747
Mailing address
1854 Portcastle Cir
Winter Garden, FL 34787-4747
Phone (786) 877-0503
Other practice location 1
725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (863) 494-1242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20220913003024 | FL | Practitioner - Nurse Practitioner | 7719362623 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1854 Portcastle Cir
Winter Garden, FL 34787-4747
Phone (786) 877-0503
Hospital & facility affiliations
- Adventhealth Orlando
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11021024 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balanced Wellbeing LLC | Current | Accepting new patients | |
| MCR Health, Inc. | Current | Accepting new patients | |
| MCR Health, Inc. | Current | Accepting new patients | |
| Elevating Your Health LLC | Psychiatric/Mental Health | Current | Accepting new patients |
Locations
725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242
3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200
12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231
Organizations & group practices 4
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Winter Garden, FL
- NPI 1316728496
FL, Psychiatric/Mental Health
-
- Non-Pharmacy Dispensing Site
- Bradenton, FL
- NPI 1821878745
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Orlando, FL
- NPI 1306938071
Hospital
-
- Clinical Medical Laboratory
- Orlando, FL
- NPI 1801569728
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665619200000",
"number": "1770219701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1854 PORTCASTLE CIR",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347874747",
"telephone_number": "786-877-0503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1854 PORTCASTLE CIR",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347874747",
"telephone_number": "786-877-0503"
}
],
"practiceLocations": [
{
"address_1": "725 N 12th Ave Bldg B",
"address_purpose": "LOCATION",
"city": "Arcadia",
"state": "FL",
"postal_code": "342668752",
"country_code": "US",
"telephone_number": "863-494-1242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENJAMIN",
"first_name": "PAUL",
"middle_name": "ANSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-01",
"last_updated": "2022-10-13",
"certification_date": "2022-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "11021024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winter Garden, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.