Jessica Benjamin, PA-C
Individual provider Active NPI Physician Assistant · Iselin, NJ
NPI 1992439251 · NPPES record last updated Sep 29, 2022
Key facts
- NPI
- 1992439251
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00700900 (NJ)
- Practice address
- 5 Dundee Ave
Iselin, NJ 08830-2118 - Phone
- (732) 404-0044
- NPI assigned
- Jul 13, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221208001408 | NJ | Practitioner - Physician Assistant | 0941679252 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00700900 | NJ | MD | Physician Assistant |
Interoperability endpoints
- jessica.benjamin.1@33739.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00700900 | NJ | Yes |
Addresses
Primary practice location
5 Dundee Ave
Iselin, NJ 08830-2118
Mailing address
7 Redbud Rd
Piscataway, NJ 08854-5926
Other providers in Iselin, NJ
- Francis Valeria Barrantes
- Bayada Home Health Care, Inc.
- Bayada Home Health Care, Inc.
- Beatitud Wellness LLC
- Tanya Beckman
- Adrena Bennett
- Annie Laurie Benzie
- Berliant Sleep Services
- Berliant Sleep Services LLC
- Nicolette Bernabeu
All providers in Iselin, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2022. 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.