Active NPI
Benjamin James Archer, M.D.
- Emergency Medicine Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- M-2199
- Practice address
- 34800 Bob Wilson Dr
San Diego, CA 92134-1098 - Phone
- (650) 269-8304
- NPI assigned
- Mar 31, 2013
- Last updated
- Mar 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | M-2199 | GU | Primary |
Addresses
Primary practice location
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Mailing address
US Naval Hospital Guam, Emergency Medicine, DMS PSC 455
Box 208
Fpo, AP 96540
Phone (671) 482-4197
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GU, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Tulane University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2300 Opitz Blvd
Woodbridge, VA 22191-3311
Phone (703) 523-1000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-2199 | GU | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guam Healthcare Development Incorporated | Current | Accepting new patients | |
| Emergency Coverage, LLC | Emergency Medicine | Current | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
133 Route 3
Dededo, GU 96929
Phone (671) 645-5500
12825 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 523-9800
2300 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 523-1000
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.
-
dba Emergency Coverage Corporation of TeamHealth
- Family Medicine Physician
- Newport, TN
- NPI 1427005008
Emergency Medicine, VA
-
dba GRMC Specialty Care Center
- Clinic/Center
- Dededo, GU
- NPI 1326447939
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sentara Northern Virginia Medical Center
- General Acute Care Hospital
- Woodbridge, VA
- NPI 1548366404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1790028561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "US NAVAL HOSPITAL GUAM, EMERGENCY MEDICINE, DMS PSC 455",
"address_2": "BOX 208",
"city": "FPO",
"state": "AP",
"postal_code": "96540",
"telephone_number": "671-482-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "650-269-8304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHER",
"first_name": "BENJAMIN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-03-31",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GU",
"license": "M-2199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.