Tanner Benson, is a medicare enrolled "Physical Therapist" provider in Sparland, Illinois. His current practice location is
36 Sauk Ct, Sparland, Illinois. You can reach out to his office (for appointments etc.) via phone at
(309) 371-5350.
Tanner Benson is licensed to practice in Illinois (license number 070025342) 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 1194197806.
Healthcare Provider's Profile
| Full Name | Tanner Benson |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 36 Sauk Ct, Sparland, Illinois |
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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: 1194197806
- Provider Enumeration Date: 10/21/2015
- Last Update Date: 01/28/2025
Medicare PECOS Information:
- PECOS PAC ID: 1557774692
- Enrollment ID: I20210108000942
Medical Identifiers
Medical identifiers for Tanner Benson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194197806 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | PT-2024-0345 (New Mexico) | Secondary |
| 225200000X | Physical Therapy Assistant | 2116126 (Texas) | Secondary |
| 225200000X | Physical Therapy Assistant | 160006710 (Illinois) | Secondary |
| 225100000X | Physical Therapist | 070025342 (Illinois) | 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. Tanner Benson allows following entities to bill medicare on his behalf.
| Provider Name | Aegis Group Practice Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1275259798
PECOS PAC ID: 5193036432
Enrollment ID: O20221130001868 |
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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. Tanner Benson 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 |
|---|
Tanner Benson,
36 Sauk Ct,
Sparland, IL 61565-9409
Ph: (309) 371-5350 | Tanner Benson,
36 Sauk Ct,
Sparland, IL 61565-9409
Ph: (309) 371-5350 |
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