Benjamin Affenito
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Philadelphia, PA
NPI 1982469409 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1982469409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 909 Walnut St Ste 300
Philadelphia, PA 19107-5211 - Phone
- (617) 286-4960
- NPI assigned
- Feb 14, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250709001535 | PA | Order and Referring Only - Oral Surgery |
6406360700 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
909 Walnut St Ste 300
Philadelphia, PA 19107-5211
Mailing address
909 Walnut St Ste 300
Philadelphia, PA 19107-5211
Phone (617) 286-4960
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.