Individual provider Active NPI

Benedicto V Bituin, DPM

  • Podiatrist
  • Atlanta, GA
National Provider Identifier
1932216405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000819 Issued in GA
Practice address
315 Boulevard NE
Suite 200
Atlanta, GA 30312-1200
Phone
(404) 265-4644
NPI assigned
Aug 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000819 GA Primary

Addresses

Primary practice location

315 Boulevard NE
Suite 200
Atlanta, GA 30312-1200

Mailing address

315 Boulevard NE
Suite 200
Atlanta, GA 30312-1200
Phone (404) 265-4644

Other identifiers 1

IdentifierTypeStateIssuer
00783956BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000217 GA Practitioner - Podiatry 7810921517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000819GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
William C Stoll LLC Podiatrist CurrentSince Mar 23, 2009 Accepting new patients
Antioch Vascular Center, LLC PastSince Feb 17, 2018 Accepting new patients
Advanced Health & Rehab Center Inc PastSince Nov 1, 2010 Accepting new patients
Vitale Medical Inc Past Accepting new patients
Allstar Foot Care Center LLC Podiatrist PastSince May 1, 2011 Accepting new patients

Locations

3193 Howell Mill Rd NW
Ste 326
Atlanta, GA 30327
Phone (404) 355-4522

Organizations & group practices 5

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932216405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121200",
            "telephone_number": "404-265-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BOULEVARD NE",
            "address_2": "SUITE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121200",
            "telephone_number": "404-265-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BITUIN",
        "first_name": "BENEDICTO",
        "middle_name": "V",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00783956B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.