NPIMap

Individual provider Active NPI

Benito A Pedraza

  • Gastroenterology Physician
  • Ventura, CA
National Provider Identifier
1851323026
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A78582 Issued in CA
Practice address
168 N Brent St
Ste 404
Ventura, CA 93003
Phone
(805) 641-6525
Fax
(805) 641-6530
NPI assigned
Jul 7, 2006
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A78582 CA Primary

Addresses

Primary practice location

168 N Brent St
Ste 404
Ventura, CA 93003

Mailing address

168 N Brent St
Ste 404
Ventura, CA 93003
Phone (805) 641-6525

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address benito.pedraza@ventura.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060825000487 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 1850395260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Temple University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Covington Menz Lyche and Lin Medical GPGroup PAC ID 2860449865, 9 clinicians

Practice addresses (Care Compare)

168 N Brent St
Suite 404
Ventura, CA 93003-2824
Phone (805) 641-6525

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy160
Upper gastrointestinal (GI) endoscopy for acid reflux175

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78582CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Ventura CurrentSince May 12, 2006 Accepting new patients
Island View Gastroenterology Assoc. Gastroenterology CurrentSince Jul 5, 2006 Accepting new patients
County of Ventura CurrentSince May 12, 2006 Accepting new patients
County of Ventura Current Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Community Memorial Health System Past Accepting new patients

Locations

2240 E Gonzales Rd
Oxnard, CA 93036
Phone (805) 981-5101

168 N Brent St
Ste 404
Ventura, CA 93003
Phone (805) 641-6525

300 Hillmont Ave
Ventura, CA 93003
Phone (805) 652-6000

800 S Victoria Ave
#L4640
Ventura, CA 93009

Interoperability endpoints

  • Direct secure messaging: benito.pedraza@ventura.cernerdirect.com
  • Direct secure messaging: benitopedraza@ivga.allscriptsdirect.net
  • Direct secure messaging: benitopedraza@neurosurgi.allscriptsdirect.net

Organizations & group practices 6

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 12

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1851323026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 N BRENT ST",
            "address_2": "STE 404",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-641-6525",
            "fax_number": "805-641-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N BRENT ST",
            "address_2": "STE 404",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "93003",
            "telephone_number": "805-641-6525",
            "fax_number": "805-641-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRAZA",
        "first_name": "BENITO",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A78582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benito.pedraza@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "300 Hillmont Ave",
            "city": "Ventura",
            "state": "CA",
            "country_code": "US",
            "postal_code": "930031651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.