Mark Benjamin, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD026817E Issued in PA

Practice address

9501 Roosevelt Blvd
Suite #208
Philadelphia, PA 19114-1025

Phone

(215) 969-2300

Fax

(215) 969-2327

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992760185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "SUITE #208",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141025",
            "telephone_number": "215-969-2300",
            "fax_number": "215-969-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "SUITE #208",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141025",
            "telephone_number": "215-969-2300",
            "fax_number": "215-969-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD026817E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065803",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0907010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Christopher Benjamin, DO
• Joseph M Benjamin, MD
• Kimberly Thomas Benjamin, MD
• Lior Benjamin, M.D.
• Lydia Benjamin, MED, ATC
• Neal L Benjamin
• Benjamin Benjamini, DC
• Renee Benjamini
• Stephanie Lynne Benko, PA-C
• Allyson A Bennek Rogers, PT

• Specialist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.