Individual provider Active NPI

John C Bambenek III, MD

  • Psychiatry Physician
  • Evansville, IN
National Provider Identifier
1821020819
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01047200A Issued in IN
Practice address
2015 Maxwell Avenue
Evansville, IN 47711
Phone
(812) 422-7974
Fax
(812) 422-8163
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01047200A IN Primary

Addresses

Primary practice location

2015 Maxwell Avenue
Evansville, IN 47711

Mailing address

2015 Maxwell Avenue
Evansville, IN 47711
Phone (812) 422-7974

Other identifiers 1

IdentifierTypeStateIssuer
200149890AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040128000218 IN Practitioner - Psychiatry 8628971744 Practice locations: Evansville, IN

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Minnesota Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2015 Maxwell Ave
Evansville, IN 47711-4359
Phone (812) 422-7974

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047200AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cindy Ledbetter Psychiatric NP LLC Current Accepting new patients

Locations

2015 Maxwell Ave
Evansville, IN 47711
Phone (812) 422-7974

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1821020819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 MAXWELL AVENUE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47711",
            "telephone_number": "812-422-7974",
            "fax_number": "812-671-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 MAXWELL AVENUE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47711",
            "telephone_number": "812-422-7974",
            "fax_number": "812-422-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBENEK",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01047200A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200149890A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.