Lesly Matthew Benodin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16911 Issued in TX

Practice address

1289 University Dr
College Station, TX 77840-1559

Phone

(936) 900-6007

NPI assigned

Jan 8, 2021

Last updated

Jun 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Eagle Butte Indian Health Service HospitalGroup PAC ID 7517852759, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eagle Butte Indian Health Service Hospital Hospital, Eagle Butte, SD, CCN 431383

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• DCS Medical PA

  dba Integrity Urgent Care

  • Urgent Care Clinic/Center
  • Princeton, TX
  • NPI 1285082768
  Medicare reassignment Care Compare group NPD
• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  TX

  Medicare reassignment Care Compare group
• DCS Medical PA

  dba Integrity Urgent Care

  • Rural Health Clinic/Center
  • Bonham, TX
  • NPI 1063138741
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eagle Butte Indian Health Service Hospital

  • Public Health or Welfare Agency
  • Eagle Butte, SD
  • NPI 1558395848

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1841888484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 FM 3179 RD",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773402068",
            "telephone_number": "936-900-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 UNIVERSITY DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778401559",
            "telephone_number": "936-900-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENODIN",
        "first_name": "LESLY",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-08",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Sue Belter, PH.D.
• Hannah Elizabeth Benavides
• Kevin L Benham, 10665TG OD
• Vivian Benjamin, RBT
• Lori Benn
• Jon A. Bergeron Jr., P.H.D.
• Gadiel A Berrio, M.D.
• Nancy M. Bertsch, M.D.
• Jared Allen Berwick, BE, RBT
• David Berzon, M.D.

• Physician Assistant in College Station, TX
• Providers in College Station, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.