Individual provider Active NPI

David Bencomo, MD

  • Internal Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1922297191
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 98872 Issued in FL
Practice address
11460 Pines Blvd
Pembroke Pines, FL 33026-4128
Phone
(954) 420-8819
NPI assigned
Oct 23, 2007
Last updated
Mar 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 98872 FL Primary

Addresses

Primary practice location

11460 Pines Blvd
Pembroke Pines, FL 33026-4128

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Other practice location 1

137 S Compass Way
Dania Beach, FL 33004-2369
Phone (954) 642-2903

Other identifiers 1

IdentifierTypeStateIssuer
ME 98872OtherFLFLORIDA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david.bencomo.1@29601.direct.athenahealth.com Direct

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
I20080819000359 FL Practitioner - Internal Medicine 0547335077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

11460 Pines Blvd
Pembroke Pines, FL 33026-4128
Phone (954) 433-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 98872FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC Internal Medicine CurrentSince Apr 20, 2020 Accepting new patients
Conviva Specialty, LLC PastSince Sep 25, 2022 Accepting new patients

Locations

137 S Compass Way
Dania Beach, FL 33004
Phone (954) 642-2903

6221 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 491-1686

1460 E Hallandale Beach Blvd
Hallandale Beach, FL 33009
Phone (954) 455-2385

1460 E Hallandale Beach Blvd
Ste 103
Hallandale Beach, FL 33009

440 W 49th St
Hialeah, FL 33012
Phone (305) 828-5000

1316 N State Road 7
Margate, FL 33063
Phone (954) 968-9993

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6101 Blue Lagoon Dr
Ste 400
Miami, FL 33126
Phone (305) 500-2114

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

11460 Pines Blvd
Pembroke Pines, FL 33026
Phone (954) 433-4200

3 SW 129th Ave
Ste 101
Pembroke Pines, FL 33027
Phone (954) 433-4200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1922297191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11460 PINES BLVD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330264128",
            "telephone_number": "954-420-8819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 S Compass Way",
            "address_purpose": "LOCATION",
            "city": "Dania Beach",
            "state": "FL",
            "postal_code": "330042369",
            "country_code": "US",
            "telephone_number": "954-642-2903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENCOMO",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-23",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 98872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "ME 98872",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.bencomo.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11460 Pines Blvd",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330264128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.