Individual provider Active NPI

Erika Broslat Benfield, FNP-C

  • Family Nurse Practitioner
  • Fredericksburg, TX
National Provider Identifier
1902156524
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
779618 Issued in TX
Practice address
200 W Windcrest St
Cornerstone Clinic
Fredericksburg, TX 78624-4481
Phone
(830) 997-0330
Fax
(830) 997-7601
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 779618 TX Primary

Addresses

Primary practice location

200 W Windcrest St
Cornerstone Clinic
Fredericksburg, TX 78624-4481

Mailing address

200 W Windcrest St
Cornerstone Clinic
Fredericksburg, TX 78624-4481
Phone (830) 997-0330

Other identifiers 3

IdentifierTypeStateIssuer
885N62OtherTXBCBSTX
310837501MedicaidTX
P01108626OtherMEDICARE RAILROAD

Other names 1

  • Erika Dawn Broslat Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121002000727 TX Practitioner - Nurse Practitioner 9537318878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

815 Front St
Comfort, TX 78013-2626
Phone (830) 995-5633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
779618TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg Family Clinic PA CurrentSince Oct 1, 2012 Accepting new patients
Fredericksburg Family Clinic PA CurrentSince Oct 1, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: erika.benfield@cornerstone.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384819200000",
    "number": "1902156524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W WINDCREST ST",
            "address_2": "CORNERSTONE CLINIC",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244481",
            "telephone_number": "830-997-0330",
            "fax_number": "830-997-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W WINDCREST ST",
            "address_2": "CORNERSTONE CLINIC",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244481",
            "telephone_number": "830-997-0330",
            "fax_number": "830-997-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENFIELD",
        "first_name": "ERIKA",
        "middle_name": "BROSLAT",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2013-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "779618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "885N62",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310837501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01108626",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIKA",
            "last_name": "BROSLAT",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.