Kristin Michelle Bennett, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

A94636 Issued in CA

Practice address

10200 Trinity Pkwy Ste 201
Stockton, CA 95219-7288

Phone

(209) 952-0483

Fax

(209) 478-5785

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Otolaryngology

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sacramento Ear Nose and Throat Surgical and Medical Group IncGroup PAC ID 6204905342, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084
• Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336
• Doctors Hospital of Manteca Hospital, Manteca, CA, CCN 050118

Merit-based Incentive Payment System (MIPS)

Final score

74.25 of 100Reported as group

Quality

51.19

Promoting interoperability

94

Improvement activities

40

Cost

61.73

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kbennett216059@hisp.ehr.sutterhealth.org

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.

• Sacramento Ear Nose & Throat Surgical & Medical Group Inc

  • Otolaryngology Physician
  • Sacramento, CA
  • NPI 1497758155
  Medicare reassignment Care Compare group NPD
• County of San Joaquin

  • General Acute Care Hospital
  • French Camp, CA
  • NPI 1801830583
  Medicare reassignment NPD
• San Joaquin Faculty Medical Group

  • Internal Medicine Physician
  • French Camp, CA
  • NPI 1225063761
  Medicare reassignment NPD
• County of San Joaquin

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636

  Otolaryngology

  NPD
• Excell E.N.T. Medical Group, Inc.

  • Otolaryngology Physician
  • Stockton, CA
  • NPI 1871532887
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Doctors Hospital of Manteca, Inc.

  • General Acute Care Hospital
  • Manteca, CA
  • NPI 1992736599
  Care Compare affiliation
• Lodi Memorial Hospital Association Inc

  • General Acute Care Hospital
  • Lodi, CA
  • NPI 1316938301
  Care Compare affiliation
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1922047299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EXPOSITION BLVD",
            "address_2": "BLDG 700",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154314",
            "telephone_number": "916-736-3408",
            "fax_number": "916-233-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY STE 201",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197288",
            "telephone_number": "209-952-0483",
            "fax_number": "209-478-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KRISTIN",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A94636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dejon M Bennett
• Hannah Kaylee Bennett
• Jeffrey Ryan Bennett
• Joseph Bennett
• Kaeliegh Bennett
• Passhun Bennett
• William Luther Bennett, RPH
• Bruce Benninger, DDS
• George WM. Bensch, M.D.
• Gregory William Bensch, M.D.

• Otolaryngology Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.