Active NPI
Verdale Nathaniel Benson, PA-C
- Physician Assistant
- Pleasanton, CA
National Provider Identifier
1962845750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 51372
- Practice address
- 4626 Willow Road
Suite 200
Pleasanton, CA 94588-8564 - Phone
- (925) 463-0470
- Fax
- (925) 463-0473
- NPI assigned
- Apr 10, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 51372 | CA | Primary |
Addresses
Primary practice location
4626 Willow Road
Suite 200
Pleasanton, CA 94588-8564
Mailing address
4626 Willow Road
Suite 200
Pleasanton, CA 94588-8564
Phone (925) 463-0470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51372 | Other | CA | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51372 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-Valley Orthopedic and Sports Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Pleasanton, CA
- NPI 1184808156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424044800000",
"number": "1962845750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4626 WILLOW ROAD",
"address_2": "SUITE 200",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945888564",
"telephone_number": "925-463-0470",
"fax_number": "925-463-0473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4626 WILLOW ROAD",
"address_2": "SUITE 200",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945888564",
"telephone_number": "925-463-0470",
"fax_number": "925-463-0473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENSON",
"first_name": "VERDALE",
"middle_name": "NATHANIEL",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-10",
"last_updated": "2015-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "51372",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "51372",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.