Organization Active NPI

Samuel D. Benjamin MD, MD(H), PLLC

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1801036538
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13742 Issued in AZ
Legal business name
SAMUEL D. BENJAMIN MD, MD(H), PLLC
Practice address
15721 N Greenway Hayden Loop
#103
Scottsdale, AZ 85260
Phone
(480) 661-1880
Fax
(480) 661-1890
NPI assigned
Feb 20, 2009
Last updated
Jul 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Authorized official

Name
Samuel Dorian Benjamin, MD
Title
President
Phone
(480) 661-1880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13742 AZ Primary

Addresses

Primary practice location

15721 N Greenway Hayden Loop
#103
Scottsdale, AZ 85260

Mailing address

15721 N Greenway Hayden Loop
#103
Scottsdale, AZ 85260
Phone (480) 661-1880

Other identifiers 1

IdentifierTypeStateIssuer
1063625424OtherAZNPI

National Provider Directory

National Provider Directory

Locations

12020 E Shea Blvd
Ste 7
Scottsdale, AZ 85259
Phone (480) 661-1880

15721 N Greenwy Hdn Loop
Ste 103
Scottsdale, AZ 85260
Phone (602) 362-4200

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1801036538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15721 N GREENWAY HAYDEN LOOP",
            "address_2": "#103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "480-661-1880",
            "fax_number": "480-661-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15721 N GREENWAY HAYDEN LOOP",
            "address_2": "#103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "480-661-1880",
            "fax_number": "480-661-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL D. BENJAMIN MD, MD(H), PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "BENJAMIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "DORIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-661-1880",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "13742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063625424",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.