Individual provider Active NPI

Jeffry Jense Benjamin, MD

  • Family Medicine Physician
  • Mesquite, TX
National Provider Identifier
1780146191
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T9350 Issued in TX
Practice address
125 E Grubb Dr Ste 109
Mesquite, TX 75149-3402
Phone
(972) 285-6349
Fax
(972) 289-6717
NPI assigned
Apr 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T9350 TX Primary

Addresses

Primary practice location

125 E Grubb Dr Ste 109
Mesquite, TX 75149-3402

Mailing address

125 E Grubb Dr Ste 109
Mesquite, TX 75149-3402
Phone (972) 285-6349

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220913002528 TX Practitioner - Family Practice 5496083404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

125 E Grubb Dr
109 Wellmed at Mesquite
Mesquite, TX 75149-3402
Phone (972) 285-6349

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

Hospital & facility affiliations

  • Expedient Home Health Care Home health agency, Rockwall, TX, CCN 679377

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Family Medicine CurrentSince Sep 12, 2022 Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Sep 12, 2022 Accepting new patients

Locations

207 S FM 548
#A
Forney, TX 75126
Phone (945) 536-9444

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: jeffry.benjamin@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1780146191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E GRUBB DR STE 109",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751493402",
            "telephone_number": "972-285-6349",
            "fax_number": "972-289-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E GRUBB DR STE 109",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751493402",
            "telephone_number": "972-285-6349",
            "fax_number": "972-289-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "JEFFRY",
        "middle_name": "JENSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T9350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.