Mr Benjamin R Proto, DPM | |
860 Omni Blvd, Suite 113, Newport News, VA 23606 | |
(757) 327-0657 | |
(757) 327-0658 |
Full Name | Mr Benjamin R Proto |
---|---|
Gender | Male |
Speciality | Podiatry |
Experience | 26 Years |
Location | 860 Omni Blvd, Newport News, Virginia |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073506291 | NPI | - | NPPES |
1073506291 | Medicaid | VA | |
236542 | Other | VA | ANTHEM PROVIDER NUMBER |
9304797 | Medicaid | VA | |
58381 | Other | VA | OPTIMA PROVIDER NUMBER |
394596 | Other | VA | MDIPA/MAMSI PROVIDER NUM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | 0103300835 (Virginia) | Secondary |
213E00000X | Podiatrist | 0103300835 (Virginia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Bon Secours Home Care | Suffolk, VA | Home health agency |
Sentara Careplex Hospital | Hampton, VA | Hospital |
Sentara Williamsburg Regional Medical Center | Williamsburg, VA | Hospital |
Bon Secours Mary Immaculate Hospital | Newport news, VA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Tidewater Physicians Multispecialty Group Pc | 2860398526 | 252 |
Provider Name | Tidewater Physicians Multispecialty Group Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1902848294 PECOS PAC ID: 2860398526 Enrollment ID: O20031211000980 |
Mailing Address | Practice Location Address |
---|---|
Mr Benjamin R Proto, DPM 860 Omni Blvd, Suite 303, Newport News, VA 23606 Ph: (757) 232-8777 | Mr Benjamin R Proto, DPM 860 Omni Blvd, Suite 113, Newport News, VA 23606 Ph: (757) 327-0657 |
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