Individual provider Active NPI

Benjamin Marks-Forder

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1811517303
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO3909 Issued in NV
Practice address
250 Promenade PL Apt 421
Las Vegas, NV 89106-1481
Phone
(425) 336-9224
NPI assigned
Apr 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 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 DO3909 NV Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

250 Promenade PL Apt 421
Las Vegas, NV 89106-1481

Mailing address

250 Promenade PL Apt 421
Las Vegas, NV 89106-1481
Phone (425) 336-9224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251113002242 CA Practitioner - Internal Medicine 1759761455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Hospitalist Associates a Medical CorporationGroup PAC ID 6204726102, 93 clinicians

Practice addresses (Care Compare)

1 Hoag Dr
Newport Beach, CA 92663-4162
Phone (877) 742-4624

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO3909NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Bay Area Hospitalist Medical Group Inc Internal Medicine CurrentSince Nov 1, 2025 Accepting new patients

Locations

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1811517303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PROMENADE PL APT 421",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891061481",
            "telephone_number": "425-336-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PROMENADE PL APT 421",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891061481",
            "telephone_number": "425-336-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS-FORDER",
        "first_name": "BENJAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-24",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO3909",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.