Benjamin Layne Eithun, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN1000896 Issued in MA

Practice address

E401 23Rd St
Brodhead, WI 53520-2203

Phone

(262) 701-7257

NPI assigned

Oct 20, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, IA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beithun397623@direct-ucsfmedicalcenter.org

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.

• State University of Iowa

  dba University of Iowa Health Care

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814
  Medicare reassignment NPD
• UCSF Dept of Surgery

  • Surgery Physician
  • San Francisco, CA
  • NPI 1477627537
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104

  Nurse Practitioner

  Medicare reassignment NPD
• UCSF Pediatrics Associates

  dba UCSF Medical Center

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1376614016
  Medicare reassignment NPD
• University of California San Francisco

  dba UCSF Pediatrics Group

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  dba UCSF Orthotic and Prosthetic Center - Gateway Medical Building

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  dba UCSF Medical Center

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1164512851
  NPD
• University of California San Francisco

  dba UCSF Outpatient Pharmacy at Parnassus

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD
• State University of Iowa

  dba Student Health & Wellness

  • Student Health Clinic/Center
  • Iowa City, IA
  • NPI 1285635664
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1902132376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 MERRI HILL DR",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535751001",
            "telephone_number": "608-212-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E401 23RD ST",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535202203",
            "telephone_number": "262-701-7257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "888-573-5437",
            "fax_number": "319-356-3949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EITHUN",
        "first_name": "BENJAMIN",
        "middle_name": "LAYNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-20",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5064",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C178097",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN1000896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert C Cates Sr., MD
• Jeshua Michael Delorme, DC
• Kimberlee Delorme
• Dr. Dawn a. Smith, S.C.
• Judie Ann Dullum, RN
• Jacqueline Leigh Engen, APNP-FNP
• Everside Health-Sti Brodhead
• Anne Hamel, DPT
• Carmen Huenerberg
• Iris Health Clinic

• Pediatric Nurse Practitioner in Brodhead, WI
• Providers in Brodhead, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.