Individual provider Active NPI

Yedidya Benavie, MD

  • Emergency Medicine Physician
  • Easton, PA
National Provider Identifier
1821664780
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT223424 Issued in PA
Practice address
1872 St Lukes Blvd
Easton, PA 18045-5669
Phone
(484) 526-1000
NPI assigned
Jun 1, 2021
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MT223424 PA Primary

Addresses

Primary practice location

1872 St Lukes Blvd
Easton, PA 18045-5669

Mailing address

1700 St Lukes Blvd
Easton, PA 18045-5670
Phone (484) 526-1000

Other names 1

  • Yedidya Ben-Avie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 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
I20240108005486 PA Practitioner - Emergency Medicine 6901257591 Reassigns benefits to 2 organizations
I20241016000984 MD Practitioner - Emergency Medicine 6901257591 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT223424PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. Current Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Aug 3, 2024 Accepting new patients
St Luke's Physician Group Inc CurrentSince Jan 1, 2024 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Aug 3, 2024 Accepting new patients
Gslpg, Inc CurrentSince Jan 1, 2024 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1872 St Lukes Blvd
Easton, PA 18045
Phone (484) 503-1200

1700 St Lukes Blvd
Easton, PA 18045
Phone (484) 526-4838

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

100 Paramount Blvd
Orwigsburg, PA 17961
Phone (272) 639-1000

Interoperability endpoints

  • Direct secure messaging: yedidya.benavie@slpg.direct-sluhn.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1821664780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455670",
            "telephone_number": "484-526-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1872 ST LUKES BLVD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180455669",
            "telephone_number": "484-526-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIE",
        "first_name": "YEDIDYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT223424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEDIDYA",
            "last_name": "BEN-AVIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Easton, PA

Sources for this page

Verify at the official NPI Registry.