Individual provider Active NPI

Jane M. Benton, MD

  • Pediatrics Physician
  • Orlando, FL
National Provider Identifier
1831277094
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME55220 Issued in FL
Practice address
1717 S Orange Ave
Suite 100
Orlando, FL 32806-2944
Phone
(407) 650-7000
Fax
(407) 650-7124
NPI assigned
Nov 2, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME55220 FL Primary

Addresses

Primary practice location

1717 S Orange Ave
Suite 100
Orlando, FL 32806-2944

Mailing address

PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212

Other practice location 1

220 Barton Blvd Unit C-14
Rockledge, FL 32955-2742
Phone (321) 241-6800

Other identifiers 1

IdentifierTypeStateIssuer
064620200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060320000665 FL Practitioner - Pediatric Medicine 1951318740 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME55220FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc Current Accepting new patients
Brevard Health Alliance, Inc. CurrentSince Nov 8, 2023 Accepting new patients
Brevard Health Alliance Inc CurrentSince Nov 8, 2023 Accepting new patients
The Nemours Foundation Past Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

775 Malabar Rd
Malabar, FL 32950
Phone (321) 722-8435

17 Silver Palm Ave
Melbourne, FL 32901
Phone (321) 725-9041

2120 Sarno Rd
Melbourne, FL 32935
Phone (321) 952-9696

5270 Babcock St NE
Ste 1
Palm Bay, FL 32905
Phone (321) 676-5996

7227 N US Highway 1
Port St John, FL 32927
Phone (321) 631-3693

220 Barton Blvd
Unit C14
Rockledge, FL 32955
Phone (321) 639-5177

1537 N Singleton Ave
Titusville, FL 32796
Phone (321) 268-0267

Interoperability endpoints

  • Direct secure messaging: jane.benton@bha.eclinicaldirectplus.com

Organizations & group practices 5

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1831277094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S ORANGE AVE",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062944",
            "telephone_number": "407-650-7000",
            "fax_number": "407-650-7124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Barton Blvd Unit C-14",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329552742",
            "country_code": "US",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENTON",
        "first_name": "JANE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME55220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "064620200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.