Tracy E Benjamin, PA
Individual provider Active NPI Surgical Physician Assistant · New Haven, CT
NPI 1922085885 · NPPES record last updated Apr 4, 2019
Key facts
- NPI
- 1922085885
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 000704 (CT)
- Practice address
- Yale New Haven Hospital
1450 Chapel Street
New Haven, CT 06511 - Phone
- (203) 789-3000
- NPI assigned
- Dec 30, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- JS Weill Medical College, Cornell University, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Yale University
Practice addresses (Care Compare)
1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405
800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140
Hospital & facility affiliations
- Yale-New Haven Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040921000120 | CT | Practitioner - Physician Assistant | 1456329127 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 704 | CT | MD | Genetic Counselor (M.S.) |
| 000704 | CT | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Current |
Accepting new patients | |
| Northeast Medical Group, Inc. | Current |
Accepting new patients | |
| Northeast Medical Group Inc | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients |
Locations
100 Grand St
New Britain, CT 06052
Phone (860) 224-5011
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
1450 Chapel St
New Haven, CT 06511
Phone (203) 789-3151
300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
Interoperability endpoints
- tracybenjamin@cctns.allscriptsdirect.net
- tbenjamin396087@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 000704 | CT | Yes |
Addresses
Primary practice location
Yale New Haven Hospital
1450 Chapel Street
New Haven, CT 06511
Mailing address
40 Hart St
Building a Floor 3
New Britain, CT 06052-1743
Phone (860) 225-1227
Other providers in New Haven, CT
- Amanda Marie Benfante
- Andrea L Benin
- Benjamin Psychological Services and Consulting LLC
- Christopher Benjamin
- Stephanie K Benjamin
- Harvey Bennett
- Jasmiry D Bennett
- Stephanie Amber Bennett
- Jennifer Bennick
- Michael C Bennick
All providers in New Haven, CT · Surgical Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.