Individual provider Active NPI

Laureen Eick-Benson, MSN

  • Nurse Practitioner
  • Newark, DE
National Provider Identifier
1871776393
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LB-0000215 Issued in DE
Practice address
4923 Ogletown-Stanton Road
Suite 200
Newark, DE 19713-2081
Phone
(302) 225-0451
Fax
(302) 255-0472
NPI assigned
Dec 6, 2007
Last updated
May 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LB-0000215 DE Primary
Nurse Practitioner 363L00000X AC-000070 MD

Addresses

Primary practice location

4923 Ogletown-Stanton Road
Suite 200
Newark, DE 19713-2081

Mailing address

4923 Ogletown-Stanton Road
Suite 200
Newark, DE 19713-2081
Phone (302) 225-0451

Other identifiers 1

IdentifierTypeStateIssuer
1871776393MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090225000581 MD Practitioner - Nurse Practitioner 0042376170 Reassigns benefits to 1 organization
I20090513000490 DE Practitioner - Nurse Practitioner 0042376170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates PAGroup PAC ID 9830098177, 55 clinicians

Practice addresses (Care Compare)

701 N Clayton St
Suite 401
Wilmington, DE 19805-3165
Phone (302) 421-9411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC-000070MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates PA CurrentSince Jun 1, 2010 Accepting new patients

Locations

4923 Ogletown Stanton Rd
Ste 200
Newark, DE 19713
Phone (302) 225-0451

701 N Clayton St
Ste 401
Wilmington, DE 19805
Phone (302) 225-0451

137 W High St
Ste 1A
Elkton, MD 21921
Phone (410) 620-9200

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.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306195200000",
    "number": "1871776393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN-STANTON ROAD",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "302-225-0451",
            "fax_number": "302-255-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN-STANTON ROAD",
            "address_2": "SUITE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "302-225-0451",
            "fax_number": "302-255-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICK-BENSON",
        "first_name": "LAUREEN",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2011-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LB-0000215",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "AC-000070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871776393",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.