Individual provider Active NPI

Michael Kraig Benefiel, M.D.

  • Internal Medicine Physician
  • Fountain Valley, CA
National Provider Identifier
1861855827
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A153387 Issued in CA
Practice address
17360 Brookhurst St
Fountain Valley, CA 92708-3720
Phone
(949) 340-9530
Fax
(714) 665-4680
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X A153387 CA Primary

Addresses

Primary practice location

17360 Brookhurst St
Fountain Valley, CA 92708-3720

Mailing address

17360 Brookhurst St
Fountain Valley, CA 92708-3720
Phone (657) 241-3592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190703000932 CA Practitioner - Internal Medicine 8729349840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

24411 Health Ctr Dr
Suite 680
Laguna Hills, CA 92653-3692
Phone (949) 268-4568

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153387CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Bristol Park Medical Group, Inc Internal Medicine Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

24411 Health Center Dr
Ste 680
Laguna Hills, CA 92653
Phone (949) 268-4568

Interoperability endpoints

  • Direct secure messaging: mbenefiel394321@direct.memorialcare.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1861855827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "657-241-3592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "949-340-9530",
            "fax_number": "714-665-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEFIEL",
        "first_name": "MICHAEL",
        "middle_name": "KRAIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A153387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.