Individual provider Active NPI

Benny Lee Wright, D.O.

  • Obstetrics & Gynecology Physician
  • Los Banos, CA
National Provider Identifier
1992894539
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A13319 Issued in CA
Practice address
502 Washington Ave
Los Banos, CA 93635-4649
Phone
(209) 826-4771
Fax
(209) 826-8565
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 17527 MS
Obstetrics & Gynecology Physician 207V00000X 20A13319 CA Primary

Addresses

Primary practice location

502 Washington Ave
Los Banos, CA 93635-4649

Mailing address

502 Washington Ave
Los Banos, CA 93635-4649
Phone (209) 826-4771

Other identifiers 1

IdentifierTypeStateIssuer
00125672MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141024001513 CA Practitioner - Obstetrics/Gynecology 4385631712 Reassigns benefits to 1 organization
Practice locations: Los Banos, CA

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

502 Washington Ave
Los Banos, CA 93635-4649
Phone (209) 826-4771

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13319CAMDObstetrics & Gynecology Physician
17527MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Wound Healing Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Prophete Medical Corporation Obstetrics & Gynecology Past Accepting new patients

Locations

4335 N Star Way
Ste A
Modesto, CA 95356
Phone (209) 342-5125

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bwright207907@hisp.ehr.sutterhealth.org

Organizations & group practices 2

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 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992894539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 WASHINGTON AVE",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354649",
            "telephone_number": "209-826-4771",
            "fax_number": "209-826-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 WASHINGTON AVE",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354649",
            "telephone_number": "209-826-4771",
            "fax_number": "209-826-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "BENNY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "17527",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A13319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125672",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.