Justin Baines Bennett, is a medicare enrolled "Nurse Practitioner - Family" in Williamstown, West Virginia. His current practice location is
4314 Williamstown Pike, Williamstown, West Virginia. You can reach out to his office (for appointments etc.) via phone at
(304) 482-6029.
Justin Baines Bennett is licensed to practice in West Virginia (license number 110892) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1174293138.
Provider's Profile
| Full Name | Justin Baines Bennett |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 4314 Williamstown Pike, Williamstown, West Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1174293138
- Provider Enumeration Date: 09/20/2021
- Last Update Date: 02/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 9739546359
- Enrollment ID: I20230613000457
Medical Identifiers
Medical identifiers for Justin Baines Bennett such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174293138 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WH0200X | Registered Nurse - Home Health | RN.385551 (Ohio) | Secondary |
| 207Q00000X | Family Medicine | LE-00038485 (Ohio) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 110892 (West Virginia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Justin Baines Bennett allows following entities to bill medicare on his behalf.
| Entity Name | Matrix Medical Network Of West |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942569033
PECOS PAC ID: 0244598621
Enrollment ID: O20171212001076 |
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| Entity Name | St. Joseph Recovery Center, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174021406
PECOS PAC ID: 0042548000
Enrollment ID: O20190829000101 |
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| Entity Name | Healthfair Plus Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376973461
PECOS PAC ID: 2365668720
Enrollment ID: O20230420002891 |
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| Entity Name | Grace Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376172494
PECOS PAC ID: 0941651947
Enrollment ID: O20240103004145 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin Baines Bennett is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Justin Baines Bennett,
4314 Williamstown Pike,
Williamstown, WV 26187-8083
Ph: (304) 482-6029 | Justin Baines Bennett,
4314 Williamstown Pike,
Williamstown, WV 26187-8083
Ph: (304) 482-6029 |
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