Individual provider Active NPI

Annie Zachariah Benjamin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1770829749
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
733303 Issued in TX
Practice address
2800 S Macgregor Way
Houston, TX 77021
Phone
(713) 741-6963
NPI assigned
Dec 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 733303 TX Primary

Addresses

Primary practice location

2800 S Macgregor Way
Houston, TX 77021

Mailing address

15200 Southwest Fwy
Suite 240
Sugar Land, TX 77478-3845
Phone (281) 835-5636

Other practice location 1

15200 Southwest Fwy
Suite 240
Sugar Land, TX 77478-3845
Phone (281) 835-5636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130910000161 TX Practitioner - Nurse Practitioner 6608010822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Dec 1, 2014 Accepting new patients
Ut Physicians CurrentSince Dec 1, 2014 Accepting new patients

Locations

2800 S Macgregor Way
Houston, TX 77021
Phone (713) 741-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

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, 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": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1770829749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 SOUTHWEST FWY",
            "address_2": "SUITE 240",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783845",
            "telephone_number": "281-835-5636",
            "fax_number": "281-835-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S MACGREGOR WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77021",
            "telephone_number": "713-741-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15200 Southwest Fwy",
            "address_2": "Suite 240",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774783845",
            "country_code": "US",
            "telephone_number": "281-835-5636",
            "fax_number": "281-835-5636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "ANNIE",
        "middle_name": "ZACHARIAH",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "733303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.