Individual provider Active NPI

Benjamin Michel Di Biase

  • Clinical Social Worker
  • Rosalia, WA
National Provider Identifier
1790209872
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61102181 Issued in WA
Practice address
402 John Tye Rd
Rosalia, WA 99170-9630
Phone
(509) 768-3682
NPI assigned
Jul 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4171270 ID
Clinical Social Worker 1041C0700X LW61102181 WA Primary

Addresses

Primary practice location

402 John Tye Rd
Rosalia, WA 99170-9630

Mailing address

402 John Tye Rd
Rosalia, WA 99170-9630
Phone (509) 768-3682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250703003163 WA Practitioner - Clinical Social Worker 8123532934 Reassigns benefits to 2 organizations
I20250904004251 ID Practitioner - Clinical Social Worker 8123532934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Shelton, WA 98584
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4171270IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Jun 21, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Jul 22, 2025 Accepting new patients
Lourdes Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1790209872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 JOHN TYE RD",
            "city": "ROSALIA",
            "state": "WA",
            "postal_code": "991709630",
            "telephone_number": "509-768-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 JOHN TYE RD",
            "city": "ROSALIA",
            "state": "WA",
            "postal_code": "991709630",
            "telephone_number": "509-768-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI BIASE",
        "first_name": "BENJAMIN",
        "middle_name": "MICHEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-31",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "4171270",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61102181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosalia, WA

Sources for this page

Verify at the official NPI Registry.