Individual provider Active NPI

Benjamin Carlos Jr., PT, DPT

  • Physical Therapist
  • Flagstaff, AZ
National Provider Identifier
1972245140
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-32270 Issued in AZ
Practice address
7810 N US Highway 89
Flagstaff, AZ 86004-6255
Phone
(928) 522-8375
NPI assigned
Apr 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X LPT-32270 AZ
Physical Therapist 225100000X LPT-32270 AZ Primary

Addresses

Primary practice location

7810 N US Highway 89
Flagstaff, AZ 86004-6255

Mailing address

13811 W Marshall Ave
Litchfield Park, AZ 85340-8303
Phone (602) 515-2270

Other practice location 1

5281 N 99th Ave Ste 200
Glendale, AZ 85305-3199
Phone (623) 889-0411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718001171 AZ Practitioner - Physical Therapist in Private Practice 5092196444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-32270AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation Current Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Jun 15, 2023 Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

7810 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 522-8375

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": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1972245140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13811 W MARSHALL AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853408303",
            "telephone_number": "602-515-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 N US HIGHWAY 89",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860046255",
            "telephone_number": "928-522-8375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5281 N 99th Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853053199",
            "country_code": "US",
            "telephone_number": "623-889-0411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "BENJAMIN",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "LPT-32270",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.