Individual provider Active NPI

Bennie Lavet Patmon Jr., DPM

  • Podiatrist
  • Laurel, MD
National Provider Identifier
1932468394
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00000 Issued in MD
Practice address
13950 Baltimore Ave
Laurel, MD 20707-5000
Phone
(301) 317-6800
Fax
(301) 317-5069
NPI assigned
May 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 00000 MD Primary

Addresses

Primary practice location

13950 Baltimore Ave
Laurel, MD 20707-5000

Mailing address

13950 Baltimore Ave
Laurel, MD 20707-5000
Phone (301) 317-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, OR, WA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20151218000695 DC Practitioner - Podiatry 9638470537 Reassigns benefits to 1 organization
I20181114001974 OR Practitioner - Podiatry 9638470537 Reassigns benefits to 1 organization
I20201110001855 WA Practitioner - Podiatry 9638470537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

3600 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

3620 N Interstate Ave
Portland, OR 97227-1106
Phone (800) 813-2000

9900 SE Sunnyside Rd
Clackamas, OR 97015-9777
Phone (800) 813-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue37
Removal or shaving of skin growth17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zarate Podiatry PA CurrentSince Jun 10, 2017 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 29, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Sep 10, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients

Locations

13950 Baltimore Ave
Laurel, MD 20707
Phone (301) 317-6800

7610 Carroll Ave
Ste 380
Takoma Park, MD 20912
Phone (240) 396-4871

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1932468394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13950 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-317-6800",
            "fax_number": "301-317-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-317-6800",
            "fax_number": "301-317-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATMON",
        "first_name": "BENNIE",
        "middle_name": "LAVET",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "00000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.