Jason M. Bennett, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

K1359 Issued in TX

Practice address

12838 Vista del Norte
San Antonio, TX 78216-8112

Phone

(361) 649-8434

Fax

(210) 614-1055

NPI assigned

Jul 26, 2006

Last updated

Nov 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1881618676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782791110",
            "telephone_number": "210-757-4677",
            "fax_number": "210-614-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12838 VISTA DEL NORTE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782168112",
            "telephone_number": "361-649-8434",
            "fax_number": "210-614-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JASON",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "K1359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "089904901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elston Bennett
• Emma Bennett, LCSW
• Gabriel Arlen Bennett, RN
• Girly Bennett, M.D.
• Hannah Bennett
• John Anthony Bennett, CCP
• Kinneathea Denisha Bennett, NURSE PRACTITIONER
• Linda Bennett, LCSW
• Marcie Bennett, P.A.
• Penny Bennett, PHD, MSN, NNP-BC, FN

• Anesthesiology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.