NPIMap

Individual provider Active NPI

Benjamin J Peck, MD

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1841396769
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME71672 Issued in FL
Practice address
305 Memorial Medical Pkwy Ste 401
Daytona Beach, FL 32117-5169
Phone
(386) 231-3612
Fax
(386) 231-3613
NPI assigned
Sep 16, 2006
Last updated
Nov 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME71672 FL Primary

Addresses

Primary practice location

305 Memorial Medical Pkwy Ste 401
Daytona Beach, FL 32117-5169

Mailing address

305 Memorial Medical Pkwy Ste 401
Daytona Beach, FL 32117-5169
Phone (386) 231-3612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100816000984 FL Practitioner - Family Practice 4486787223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Senior Care IncGroup PAC ID 7618397886, 32 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1595 N Williamson Blvd
Daytona Beach, FL 32117-7214
Phone (386) 259-6026

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME71672FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Senior Care Inc Family Medicine CurrentSince Nov 1, 2020 Accepting new patients

Locations

1595 N Williamson Blvd
Daytona Beach, FL 32117
Phone (386) 259-6026

290 Clyde Morris Blvd
Ormond Beach, FL 32174
Phone (386) 615-6642

Interoperability endpoints

  • Direct secure messaging: bpeck71841@adventhealth.direct-ci.com

Organizations & group practices 1

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 8

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1841396769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 401",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "386-231-3612",
            "fax_number": "386-231-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MEMORIAL MEDICAL PKWY STE 401",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175169",
            "telephone_number": "386-231-3612",
            "fax_number": "386-231-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME71672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.