Individual provider Active NPI

Martin Awiyai Benjamin, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1881960227
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
59754 Issued in AZ
Practice address
4611 E Shea Blvd Ste 230
Phoenix, AZ 85028-4259
Phone
(602) 598-5060
Fax
(602) 265-6286
NPI assigned
Mar 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 59754 AZ Primary

Addresses

Primary practice location

4611 E Shea Blvd Ste 230
Phoenix, AZ 85028-4259

Mailing address

7930 E Thompson Peak Pkwy Ste 101
Scottsdale, AZ 85255-7403
Phone (480) 418-5300

Other practice location 1

7930 E Thompson Peak Pkwy Ste 101
Scottsdale, AZ 85255-7403
Phone (480) 418-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200831002234 AZ Practitioner - General Surgery 9537478714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Arizona College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Dermatology PLLCGroup PAC ID 1557355385, 69 clinicians

Practice addresses (Care Compare)

4611 E Shea Blvd
Suite 230
Phoenix, AZ 85028-4259
Phone (602) 513-8133

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy12
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Dermatology, PLLC Plastic Surgery CurrentSince May 1, 2025 Accepting new patients
Camelback Dermatology & Skin Surgery, Inc PastSince Jul 1, 2003 Accepting new patients
Center for Dermatology, PLLC Past Accepting new patients

Locations

4512 N 40th St
Phoenix, AZ 85018
Phone (602) 954-7546

11209 N Tatum Blvd
Ste 175
Phoenix, AZ 85028
Phone (602) 652-8900

4611 E Shea Blvd
Ste 230
Phoenix, AZ 85028
Phone (602) 513-8133

14275 N 87th St
Ste 110
Scottsdale, AZ 85260
Phone (480) 223-9501

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 2

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1881960227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 E THOMPSON PEAK PKWY STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852557403",
            "telephone_number": "480-418-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 E SHEA BLVD STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284259",
            "telephone_number": "602-598-5060",
            "fax_number": "602-265-6286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7930 E Thompson Peak Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852557403",
            "country_code": "US",
            "telephone_number": "480-418-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "MARTIN",
        "middle_name": "AWIYAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "59754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.