Charlene Benjamin, NP

Individual provider Active NPI Adult Health Nurse Practitioner · Smithtown, NY

NPI 1780949776 · NPPES record last updated Jul 6, 2012

Key facts

NPI
1780949776
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
F3055181 (NY)
Practice address
257 E Middle Country Rd
Smithtown, NY 11787-2807
Phone
(631) 724-4664
Fax
(631) 360-7880
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fpa Hospital Based (423 clinicians)

Practice addresses (Care Compare)

100 TH St and Madison Ave
New York, NY 10029-6503
Phone (212) 241-6500

1176 5TH Ave
New York, NY 10029-6503
Phone (212) 241-8395

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161025000007 NY Practitioner - Nurse Practitioner 9032497128 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3055181NYMDAdult Health Nurse Practitioner

Practice roles (4 of 8)

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current
since Sep 1, 2016
Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based Current
since Sep 1, 2016
Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

2520 30th Ave
#4
Astoria, NY 11102

300 Cadman Plz W
Fl 18
Brooklyn, NY 11201
Phone (929) 210-6000

3131 Kings Hwy
Ste A4
Brooklyn, NY 11234
Phone (718) 758-1500

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

1468 Madison Ave
#175
New York, NY 10029
Phone (212) 241-8333

1176 5th Ave
Lbby
New York, NY 10029

17E E 102nd St
#6D
New York, NY 10029
Phone (212) 241-6381

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

310 E 14th St
New York, NY 10003
Phone (212) 979-4000

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

325 W 15th St
New York, NY 10011
Phone (212) 523-5938

787 11th Ave
#7
New York, NY 10019

425 W 59th St
Ste 6C6D
New York, NY 10019
Phone (212) 241-8333

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

281 1st Ave
New York, NY 10003
Phone (212) 844-1808

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

1090 Amsterdam Ave
Fl 3
New York, NY 10025
Phone (212) 523-8333

1000 10th Ave
Fl 4
New York, NY 10019
Phone (212) 523-8332

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

17 E 102nd St
#Stste6D
New York, NY 10029

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F3055181 NY Yes

Addresses

Primary practice location

257 E Middle Country Rd
Smithtown, NY 11787-2807

Mailing address

257 E Middle Country Rd
Smithtown, NY 11787-2807
Phone (631) 724-4664

Other providers in Smithtown, NY

All providers in Smithtown, NY · Adult Health Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.