NPIMap

Individual provider Active NPI

Jeff A Benjamin, DO

  • Neurology Physician
  • Myrtle Beach, SC
National Provider Identifier
1821057779
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0501 Issued in SC
Practice address
8170 Rourk St
Myrtle Beach, SC 29572-4127
Phone
(843) 449-2336
Fax
(843) 497-2505
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0501 SC Primary

Addresses

Primary practice location

8170 Rourk St
Myrtle Beach, SC 29572-4127

Mailing address

8170 Rourk Street
Myrtle Beach, SC 29572-4127
Phone (843) 449-2336

Other identifiers 13

IdentifierTypeStateIssuer
2023740OtherSCEVOLUTIONS
01838875MedicaidPA
1061000OtherWVWORK COMP
3099820OtherSCGHI
434035OtherSCONE HEALTH PLAN
6906038MedicaidNC
A156OtherNCNC UHC
1189849OtherSCFIRST HEALTH
7251177OtherSCAETNA
82645OtherSCMEDCOST
005014MedicaidSC
0504464OtherSCPHP
521523OtherSCFOCUS HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001350 SC Practitioner - Neurology 3678533858 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians

Practice addresses (Care Compare)

2 Innovation Dr
Greenville, SC 29607-5269
Phone (864) 516-1170

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

  • St Francis Hospital Home Care Home health agency, Simpsonville, SC, CCN 427049
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0501SCMDNeurology Physician
501SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Sleep Lab LLC CurrentSince Aug 1, 2011 Accepting new patients
Palmetto Sleep Lab LLC CurrentSince Aug 1, 2011 Accepting new patients
Palmetto Sleep Lab LLC CurrentSince Nov 1, 2003 Accepting new patients
St Francis Physician Services Inc CurrentSince Jan 20, 2017 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Neurology CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Palmetto Sleep Lab LLC PastSince Aug 1, 2011 Accepting new patients
St Francis Physician Services Inc Past Accepting new patients
Grand Strand Specialty Associates, LLC Neurology Past Accepting new patients
Strand Regional Specialty Past Accepting new patients
Strand Regional Specialty Past Accepting new patients

Locations

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

801 Roper Creek Dr
Greenville, SC 29615
Phone (864) 343-3553

Interoperability endpoints

  • Direct secure messaging: jeffbenjamin@crna.allscriptsdirect.net
  • Direct secure messaging: jbenjamin1149422@direct.bsmhealth.org

Organizations & group practices 12

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1821057779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 ROURK STREET",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724127",
            "telephone_number": "843-449-2336",
            "fax_number": "843-479-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 ROURK ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724127",
            "telephone_number": "843-449-2336",
            "fax_number": "843-497-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "JEFF",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "0501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVOLUTIONS",
            "identifier": "2023740",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01838875",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "1061000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "3099820",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "434035",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6906038",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC UHC",
            "identifier": "A156",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1189849",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7251177",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "82645",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005014",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "0504464",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FOCUS HEALTHCARE",
            "identifier": "521523",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.