Individual provider Active NPI

Benjamin Elliot Lippmann, D.O.

  • Psychiatry Physician
  • Lakeland, FL
National Provider Identifier
1902141773
Registry record updated Feb 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS12682 Issued in FL
Practice address
5302 S Florida Ave Ste 206
Lakeland, FL 33813-4910
Phone
(863) 289-0968
Fax
(863) 228-8532
NPI assigned
Dec 5, 2012
Last updated
Feb 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X OS12682 FL Primary

Addresses

Primary practice location

5302 S Florida Ave Ste 206
Lakeland, FL 33813-4910

Mailing address

5302 S Florida Ave Ste 206
Lakeland, FL 33813-4910
Phone (863) 289-0968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181115002264 FL Practitioner - Psychiatry 1951696921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5302 S Florida Ave
Suite 206
Lakeland, FL 33813-4910
Phone (863) 289-0968

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Psychiatry CurrentSince Sep 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Benjamin E. Lippmann, D.O., P.a. Psychiatry CurrentSince Jan 1, 2022 Accepting new patients
Christopher Davenport MD Mba PA Psychiatry PastSince Jan 26, 2022 Accepting new patients

Locations

410 S 11th St
Lake Wales, FL 33853
Phone (863) 676-1433

5302 S Florida Ave
Ste 206
Lakeland, FL 33813
Phone (863) 289-0968

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Organizations & group practices 4

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": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1902141773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 S FLORIDA AVE STE 206",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338134910",
            "telephone_number": "863-289-0968",
            "fax_number": "863-228-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 S FLORIDA AVE STE 206",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338134910",
            "telephone_number": "863-289-0968",
            "fax_number": "863-228-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPMANN",
        "first_name": "BENJAMIN",
        "middle_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-05",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS12682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.