Individual provider Active NPI

Emily Ann Bender, M.D.

  • Family Medicine Physician
  • Ukiah, CA
National Provider Identifier
1821594318
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A193810 Issued in CA
Practice address
260 Hospital Dr Ste 204
Ukiah, CA 95482-4568
Phone
(707) 467-5220
Fax
(707) 468-9179
NPI assigned
Apr 3, 2018
Last updated
Jul 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X MD2021-1013 NM
Family Medicine Physician 207Q00000X DR.0063310 CO
Family Medicine Physician 207Q00000X A193810 CA Primary
Hospitalist Physician 208M00000X A193810 CA

Addresses

Primary practice location

260 Hospital Dr Ste 204
Ukiah, CA 95482-4568

Mailing address

260 Hospital Dr Ste 204
Ukiah, CA 95482-4568
Phone (707) 467-5220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211215000122 NM Practitioner - Family Practice 5092079269 Reassigns benefits to 1 organization
I20240426003219 CA Practitioner - HospitalistPractitioner - Family Practice 5092079269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
University of Alabama School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ukiah Adventist HospitalGroup PAC ID 6406816123, shared by 5 NPIs, 136 clinicians
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

260 Hospital Dr
Ukiah, CA 95482-4568

275 Hospital Dr
Ukiah, CA 95482-4531
Phone (707) 462-3111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A193810CAMDFamily Medicine Physician
DR.0063310COMDFamily Medicine Physician
MD2021-1013NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Apr 1, 2024 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Apr 1, 2024 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Jul 8, 2024 Accepting new patients
Unm Medical Group, Inc. CurrentSince Nov 18, 2021 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Galen Inpatient Physicians, PC Hospitalist CurrentSince Jul 8, 2024 Accepting new patients
Unm Medical Group Inc CurrentSince Nov 18, 2021 Accepting new patients
Poudre Valley Health Care,Inc Past Accepting new patients
Poudre Valley Health Care Inc Past Accepting new patients

Locations

15322 Lakeshore Dr
Ste 102
Clearlake, CA 95422
Phone (707) 994-2030

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

260 Hospital Dr
Ste 204
Ukiah, CA 95482
Phone (707) 463-8032

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: ebender837396@ahs.direct-ci.com

Organizations & group practices 10

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.

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1821594318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 204",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-467-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 HOSPITAL DR STE 204",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824568",
            "telephone_number": "707-467-5220",
            "fax_number": "707-468-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2021-1013",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0063310",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A193810",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A193810",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.