NPIMap

Individual provider Active NPI

Luis M Benalcazar, M.D.

  • Internal Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1801878269
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07504600 Issued in NJ
Practice address
624 Newark Ave
Elizabeth, NJ 07208-3539
Phone
(908) 353-3626
Fax
(908) 353-3625
NPI assigned
Nov 18, 2005
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2325031 NY
Internal Medicine Physician 207R00000X 25MA07504600 NJ Primary

Addresses

Primary practice location

624 Newark Ave
Elizabeth, NJ 07208-3539

Mailing address

624 Newark Ave
Elizabeth, NJ 07208-3539
Phone (908) 353-3626

Other identifiers 1

IdentifierTypeStateIssuer
0028410MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040129000881 NJ Practitioner - Internal Medicine 6002719762 Reassigns benefits to 1 organization
I20230217002803 PR Practitioner - Internal Medicine 6002719762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ponce School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

185 Calle Progreso
Aguadilla, PR 00603-4802
Phone (787) 882-1070

624 Newark Ave
Elizabeth, NJ 07208-3539
Phone 90835336260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2325031NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CDT Diagnostix LLC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Center for Diagnosis and Treatment, LLC Internal Medicine CurrentSince Nov 9, 2004 Accepting new patients
Luis Benalcazar, MD Internal Medicine Past Accepting new patients
New York Medical and Cardiovascular Services, PC Internal Medicine Past Accepting new patients
Cardio-Med Services LLC Internal Medicine Past Accepting new patients
Comprehensive Healhtcare and Medical Services PLLC Internal Medicine Past Accepting new patients

Locations

310 Morris Ave
Ste 301
Elizabeth, NJ 07208
Phone (908) 353-3626

624 Newark Ave
Elizabeth, NJ 07208
Phone (908) 353-3626

204 Fayette St
Perth Amboy, NJ 08861
Phone (732) 293-3620

185 Calle Progreso
Aguadilla, PR 00603
Phone (787) 882-1070

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1801878269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083539",
            "telephone_number": "908-353-3626",
            "fax_number": "908-353-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083539",
            "telephone_number": "908-353-3626",
            "fax_number": "908-353-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENALCAZAR",
        "first_name": "LUIS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "2325031",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07504600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028410",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.