Anthony Arlo Bennett, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036112710 Issued in IL

Practice address

1899 Orchard Lake Rd
Suite 104
Sylvan Lake, MI 48320-1774

Phone

(248) 894-8019

Fax

(248) 693-4632

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI, NY, IL, CT4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians

VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

NDS Radiology PLLCGroup PAC ID 2062408875, 15 clinicians

Maryland Imaging Network PCGroup PAC ID 6103259304, 79 clinicians

Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians

Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Lapeer Medical Diagnostics PCGroup PAC ID 9133359599, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093
• Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
• Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (41 of 45)

Locations (25 of 55)

Networks

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

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.

• Alliance Physician Services of Michigan, P.C.

  • Urology Physician
  • St Clair Shores, MI
  • NPI 1427027416

  Diagnostic Radiology, MI

  Medicare reassignment Care Compare group NPD
• Cira Michigan PC

  • Diagnostic Radiology Physician
  • Escanaba, MI
  • NPI 1972141513

  Diagnostic Radiology, MI

  Medicare reassignment Care Compare group NPD
• Lapeer Medical Diagnostics PC

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1316376858

  Diagnostic Radiology, MI

  Medicare reassignment Care Compare group NPD
• NDS Radiology Inc.

  • Diagnostic Radiology Physician
  • Novi, MI
  • NPI 1649418211

  Diagnostic Radiology, MI

  Medicare reassignment Care Compare group NPD
• VMD Primary Providers Eastern Michigan, PC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1336625540

  MI

  Medicare reassignment Care Compare group NPD
• Central Illinois Radiological Associates, LTD.

  • Diagnostic Radiology Physician
  • Peoria, IL
  • NPI 1538192828

  Diagnostic Radiology, MI

  Medicare reassignment Care Compare group NPD
• Maryland Imaging Network PC

  • Diagnostic Radiology Physician
  • Prince Frederick, MD
  • NPI 1487296471

  Diagnostic Radiology, MI

  Medicare reassignment Care Compare group NPD
• Cosmetic Dermatology and Vein Centers of Downriver PC

  • Dermatology Physician
  • Riverview, MI
  • NPI 1750494282

  MI

  Medicare reassignment NPD
• Lee Internal Medicine Associates PLLC

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1821441783

  MI

  Medicare reassignment NPD
• Med-Share, Inc

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1790960342

  Diagnostic Radiology, MI

  Medicare reassignment NPD
• Northland Radiology Inc

  • Diagnostic Radiology Physician
  • Southfield, MI
  • NPI 1386804060

  Diagnostic Radiology, MI

  Medicare reassignment NPD
• Park Family Health Care, P.C.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1437161437

  MI

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mendota Community Hospital

  • Critical Access Hospital
  • Mendota, IL
  • NPI 1609803113

  Hospital

  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Evergreen Park, IL
  • NPI 1215572045

  Hospital

  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Danville, IL
  • NPI 1699288449

  Hospital

  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1801866397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 FRANKLIN WRIGHT BLVD",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621585",
            "telephone_number": "248-894-8019",
            "fax_number": "248-693-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 ORCHARD LAKE RD",
            "address_2": "SUITE 104",
            "city": "SYLVAN LAKE",
            "state": "MI",
            "postal_code": "483201774",
            "telephone_number": "248-894-8019",
            "fax_number": "248-693-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 W Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600508409",
            "country_code": "US",
            "telephone_number": "815-334-5566",
            "fax_number": "815-759-4008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANTHONY",
        "middle_name": "ARLO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "AB063302",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036112710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AB063302",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "700H219330",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "3009301771",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "MI3594001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammad Nurul Amin, MD
• Sneha Bency
• Inger Blair
• Center Visions Optical
• Clarity Visions, PLLC
• Aisha Cunningham
• Deaf Community Advocacy Network, Inc.

• All providers in Sylvan Lake, MI
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.

Verify at the official NPI Registry.