Individual provider Active NPI

Benjamin Nato Plata, PASTOR

  • Contractor
  • National City, CA
National Provider Identifier
1811171366
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
BL3225-07 Issued in CA
Practice address
616 E 8TH St
National City, CA 91950-2439
Phone
(619) 434-6632
Fax
(619) 434-4919
NPI assigned
Dec 19, 2007
Last updated
Dec 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X BL3225-07 CA Primary

Addresses

Primary practice location

616 E 8TH St
National City, CA 91950-2439

Mailing address

616 E 8TH St
National City, CA 91950-2439
Phone (619) 434-6632

Other identifiers 1

IdentifierTypeStateIssuer
D08608787OtherCAEDI SUBMITTER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BL3225-07CAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nehemiah Hospice Inc Current Accepting new patients
Hanani 1 Hospice Current Accepting new patients

Locations

616 E 8th St
National City, CA 91950
Phone (619) 434-6632

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1811171366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E 8TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502439",
            "telephone_number": "619-434-6632",
            "fax_number": "619-434-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E 8TH ST",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502439",
            "telephone_number": "619-434-6632",
            "fax_number": "619-434-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLATA",
        "first_name": "BENJAMIN",
        "middle_name": "NATO",
        "name_prefix": "Mr.",
        "credential": "PASTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-19",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CA",
            "license": "BL3225-07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDI SUBMITTER ID",
            "identifier": "D08608787",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.