Active NPI
Bryan Patrick Bennett, DO
- Surgery Physician
- Jackson, MI
National Provider Identifier
1942737549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 8426
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 205-7182
- Fax
- (517) 205-7050
- NPI assigned
- May 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Surgery Physician | 208600000X | 8426 | OK | Primary |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-7182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
608 NW 9TH St
Suite 2200
Oklahoma City, OK 73102-1049
Phone (405) 231-3737
Hospital & facility affiliations
- SSM Health St Anthony Hospital - Oklahoma City
- SSM Health St Anthony Hospital - Midwest
- SSM Health St Anthony Hospital - Shawnee
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.96 of 100
- Quality
- 80.43
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.76
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 28 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saints Medical Group, LLC | Current | Accepting new patients | |
| Saints Medical Group, LLC | Current | Accepting new patients | |
| SSM Health Care of Oklahoma, Inc. | Past | Accepting new patients |
Locations
608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737
Interoperability endpoints
- bbennett519022@direct-ehr-ssmhc.com
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Oklahoma City, OK
- NPI 1437195922
-
- Durable Medical Equipment & Medical Supplies
- Edmond, OK
- NPI 1730907700
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1366545311
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Midwest City, OK
- NPI 1700471497
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1366545311
-
- General Acute Care Hospital
- Shawnee, OK
- NPI 1134123193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1942737549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-205-7182",
"fax_number": "517-205-7050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-205-7182",
"fax_number": "517-205-7050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "BRYAN",
"middle_name": "PATRICK",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-15",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "8426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.