Individual provider Active NPI

Kalio Stephanie Benao, PHARMD, PA-C

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1821544099
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61366477 Issued in WA
Practice address
406 S 30TH Ave Ste 101
Yakima, WA 98902-3713
Phone
(509) 248-7715
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60637813 WA
Physician Assistant 363A00000X PA61366477 WA Primary
Pharmacist 183500000X P7456 ID

Addresses

Primary practice location

406 S 30TH Ave Ste 101
Yakima, WA 98902-3713

Mailing address

2811 Tieton Dr
Yakima, WA 98902-3799
Phone (509) 575-8255

Other practice location 1

1600 E Chestnut Ave
Yakima, WA 98901-2174
Phone (509) 248-3855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230308000962 WA Practitioner - Physician Assistant 3375916687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

406 S 30TH Ave
Yakima, WA 98902-3713

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
P7456IDMDPharmacist
PH60637813WAMDPharmacist
PA61366477WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Jan 30, 2023 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jan 30, 2023 Accepting new patients
Yakima Valley Memorial Physicians PastSince Aug 2, 2020 Accepting new patients

Locations

406 S 30th Ave
Ste 101
Yakima, WA 98902
Phone (509) 248-7715

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Interoperability endpoints

  • Direct secure messaging: kbenao771603@direct.multicare.org

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 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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1821544099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023799",
            "telephone_number": "509-575-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE STE 101",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713",
            "telephone_number": "509-248-7715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 E Chestnut Ave",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989012174",
            "country_code": "US",
            "telephone_number": "509-248-3855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENAO",
        "first_name": "KALIO",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60637813",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61366477",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.