NPIMap

Individual provider Active NPI

Brent L. Bennett, M.D.

  • Internal Medicine Physician
  • Lakeway, TX
National Provider Identifier
1871561035
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G3150 Issued in TX
Practice address
2300 Lohmans Spur
#106
Lakeway, TX 78734-6206
Phone
(512) 263-7133
Fax
(512) 263-0451
NPI assigned
Mar 14, 2006
Last updated
Oct 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G3150 TX Primary

Addresses

Primary practice location

2300 Lohmans Spur
#106
Lakeway, TX 78734-6206

Mailing address

2300 Lohmans Spur
#106
Lakeway, TX 78734-6206
Phone (512) 263-7133

Other identifiers 3

IdentifierTypeStateIssuer
128045506MedicaidTX
8K9640OtherTXBCBS OF TEXAS INDIVIDUAL #
P00123870OtherTXRAILROAD MEDICARE INDIVIDUAL #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040615000293 TX Practitioner - Internal Medicine 0840274403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical Branch at Galveston, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2300 Lohmans Spur Rd
Suite 106
Lakeway, TX 78734-6241
Phone (512) 263-7133

3405 El Salido Pkwy
Cedar Park, TX 78613-5640
Phone (512) 270-2247

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
18.52 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
61.74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brent Bennett MD PA Internal Medicine CurrentSince Feb 4, 2004 Accepting new patients
Hospital Internists of Austin, P.a. Past Accepting new patients

Locations

2300 Lohmans Spur Rd
Ste 106
Lakeway, TX 78734
Phone (512) 263-7133

Organizations & group practices 3

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 10

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222992000000",
    "number": "1871561035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LOHMANS SPUR",
            "address_2": "#106",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346206",
            "telephone_number": "512-263-7133",
            "fax_number": "512-263-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LOHMANS SPUR",
            "address_2": "#106",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346206",
            "telephone_number": "512-263-7133",
            "fax_number": "512-263-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BRENT",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G3150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128045506",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS INDIVIDUAL #",
            "identifier": "8K9640",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE INDIVIDUAL #",
            "identifier": "P00123870",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

Verify at the official NPI Registry.