Justin C. Benedict, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

75195 Issued in NM

Practice address

535 S Miranda St
Las Cruces, NM 88005-2823

Phone

(575) 647-2800

Fax

(575) 647-2898

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• La Clinica de Familia, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1528424397
  Medicare reassignment NPD
• Senior Psychcare of San Antonio I, PLLC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1225324270

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Vista Health Clinic & Rehab LLC

  • Sports Physician Chiropractor
  • El Paso, TX
  • NPI 1548508732
  NPD (past) Authorized official
• La Clinica de Familia, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1134917040
  NPD
• La Clinica de Familia, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1740286863
  NPD

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1972551398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S MIRANDA ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052823",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10600 Montwood Dr",
            "address_2": "Suite 119",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799352704",
            "country_code": "US",
            "telephone_number": "915-591-0680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "JUSTIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1118035",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "75195",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8790",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lowell Montana Bencomo, ATC
• Margo G Bencomo
• Natalie Bencomo, SLP-CCC
• Emma Ester Bendana, M.D.
• Stephen David Bendel
• Louis M Benevento, MD
• Xochitl Benitez, PHARMD, PHC
• Divine Bennett
• Robert Bennett, RPH
• Vicki L Bennett, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.