Individual provider Active NPI

James B Benigno Jr., O.D.

  • Optometrist
  • Pass Christian, MS
National Provider Identifier
1881812709
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
614 Issued in MS
Practice address
205 E Second St
Pass Christian, MS 39571-4422
Phone
(228) 452-0830
Fax
(228) 452-0870
NPI assigned
Apr 23, 2007
Last updated
Nov 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 614 MS Primary

Addresses

Primary practice location

205 E Second St
Pass Christian, MS 39571-4422

Mailing address

PO Box 687
Pass Christian, MS 39571-0687
Phone (228) 452-0830

Other identifiers 1

IdentifierTypeStateIssuer
00880092MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111123000677 MS Practitioner - Optometry 6002997699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 E 2ND St
Pass Christian, MS 39571-4422
Phone (228) 452-0830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Eyecare, PLLC Optometrist CurrentSince Apr 29, 1997 Accepting new patients

Locations

205 E Second St
Pass Christian, MS 39571
Phone (228) 452-0830

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1881812709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "city": "PASS CHRISTIAN",
            "state": "MS",
            "postal_code": "395710687",
            "telephone_number": "228-452-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E SECOND ST",
            "city": "PASS CHRISTIAN",
            "state": "MS",
            "postal_code": "395714422",
            "telephone_number": "228-452-0830",
            "fax_number": "228-452-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENIGNO",
        "first_name": "JAMES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880092",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pass Christian, MS

Sources for this page

Verify at the official NPI Registry.