Individual provider Active NPI

Patrick Dillon Bender

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1780074500
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60858286 Issued in WA
Practice address
303 E Chicago Ave
Ward 1-003
Chicago, IL 60611-4296
Phone
(312) 503-8798
NPI assigned
Feb 1, 2015
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60858286 WA Primary

Addresses

Primary practice location

303 E Chicago Ave
Ward 1-003
Chicago, IL 60611-4296

Mailing address

303 E Chicago Ave
Ward 1-003
Chicago, IL 60611-4296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715003370 WA Practitioner - Emergency Medicine 9830405471 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Sound Emergency Medicine PCGroup PAC ID 5496646754, 38 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

1700 13TH St
Everett, WA 98201-1689
Phone (425) 259-0212

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60858286WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Sound Emergency Medicine PC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Providence Health & Services- Washington CurrentSince Aug 1, 2019 Accepting new patients
Providence Health & Services - Washington CurrentSince Aug 1, 2019 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1422748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1780074500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E CHICAGO AVE",
            "address_2": "WARD 1-003",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E CHICAGO AVE",
            "address_2": "WARD 1-003",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114296",
            "telephone_number": "312-503-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "PATRICK",
        "middle_name": "DILLON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-01",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60858286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.