Individual provider Active NPI

Robert Emmanuel Benjamin, M.D.

  • Surgical Critical Care Physician
  • La Crosse, WI
National Provider Identifier
1992763395
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
71047 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X ME87533 FL
Surgical Critical Care Physician 2086S0102X 71047 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

301 E Main St
Bay Shore, NY 11706-8458
Phone (631) 390-7100

Other practice location 1

301 E Main St
Bay Shore, NY 11706-8458
Phone (631) 390-7100 ext. 5339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, WI, VI, TX5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20100303000989 FL Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 9537248562 Reassigns benefits to 3 organizations
I20190615000086 GA Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 9537248562 Reassigns benefits to 1 organization
I20190917001251 WI Practitioner - General Surgery 9537248562 Reassigns benefits to 1 organization
I20200109002760 VI Practitioner - Critical Care (Intensivists) 9537248562 Reassigns benefits to 1 organization
I20260123003057 TX Practitioner - General Surgery 9537248562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Trauma Services LLCGroup PAC ID 3971985938, 92 clinicians
Arlington Physician Services PAGroup PAC ID 8224256961, 43 clinicians

Practice addresses (Care Compare)

1401 S Seminole Blvd
Sanford, FL 32771-6743
Phone (407) 321-4500

1900 Pine St
Abilene, TX 79601-2432
Phone (325) 670-2000

Hospital & facility affiliations

  • Central Florida Lake Monroe Hospital Hospital, Sanford, FL, CCN 100161
  • Hendrick Medical Center Hospital, Abilene, TX, CCN 450229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
71047WIMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jul 1, 2019 Accepting new patients
Osceola Surgical Associates LLC CurrentSince Nov 1, 2022 Accepting new patients
Florida Hospital Healthcare Partners, Inc CurrentSince Jan 7, 2022 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Oct 21, 2019 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jul 1, 2019 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Sep 5, 2019 Accepting new patients
Florida Trauma Services, LLC CurrentSince Jun 16, 2022 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Oct 21, 2019 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Sep 5, 2019 Accepting new patients
Arlington Physician Services PA CurrentSince Feb 1, 2026 Accepting new patients

Locations

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

2450 N Orange Blossom Trl
Kissimmee, FL 34744
Phone (407) 846-4343

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

1887 Kingsley Ave
Ste 1900
Orange Park, FL 32073
Phone (904) 272-9981

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: robertbenjamin@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: rbenjamin318423@direct.gundersenhealth.org
  • Direct secure messaging: robert.benjamin@hca4.eclinicaldirectplus.com

Organizations & group practices 11

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1992763395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068458",
            "telephone_number": "631-390-7100",
            "fax_number": "631-390-7128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Main St",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117068458",
            "country_code": "US",
            "telephone_number": "631-390-7100 x5339",
            "fax_number": "631-390-7128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "ROBERT",
        "middle_name": "EMMANUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME87533",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WI",
            "license": "71047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.