Individual provider Active NPI

Dwight Evon Benjamin, MD, FACOG, FRCOG

  • Obstetrics & Gynecology Physician
  • Miramar, FL
National Provider Identifier
1962513648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
90059 Issued in FL
Practice address
1951 SW 172ND Ave
Suite 200
Miramar, FL 33029-5593
Phone
(954) 435-4700
Fax
(954) 435-4709
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

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
Obstetrics & Gynecology Physician 207V00000X 90059 FL Primary

Addresses

Primary practice location

1951 SW 172ND Ave
Suite 200
Miramar, FL 33029-5593

Mailing address

917 Crestview Cir
Weston, FL 33327-1848
Phone (954) 272-8350

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
I20070618000187 FL Practitioner - Obstetrics/Gynecology 0345349221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90059FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Jun 1, 2008 Accepting new patients
Flamingo Women'S Pavilion LLC Past Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

1951 SW 172nd Ave
Ste 200
Miramar, FL 33029
Phone (305) 330-6692

12600 Pembroke Rd
Ste 202
Miramar, FL 33027
Phone (954) 435-4700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962513648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 CRESTVIEW CIR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333271848",
            "telephone_number": "954-272-8350",
            "fax_number": "954-636-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 SW 172ND AVE",
            "address_2": "SUITE 200",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330295593",
            "telephone_number": "954-435-4700",
            "fax_number": "954-435-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "DWIGHT",
        "middle_name": "EVON",
        "name_prefix": "Dr.",
        "credential": "MD, FACOG, FRCOG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "90059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.