GUY RICHARD JR. BENNALLACK (DO) – Family Medicine Physician, NPI 1245610344

GUY RICHARD JR. BENNALLACK (DO) is a healthcare provider. based in Santa maria, California. specializing in EMERGENCY MEDICINE, EMERGENCY MEDICINE, OSTEOPATHIC MANIPULATIVE MEDICINE, FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. S3795 (TX). The NPI Number for GUY RICHARD JR. BENNALLACK (DO) is 1245610344

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
GUY RICHARD JR. BENNALLACK (DO)
NPI
1245610344
Phone
(805) 739-3374
Address
1400 E CHURCH ST BLDG 8
Enumeration Date
3 June 2015
Last Update Date
23 March 2020

Doctor Profile

Medical School Name
TOURO UN COLLEGE OF OSTEOPATHIC MEDICINE, VALLEJO
Secondary Phone
8087752211
Graduation Year
2015 (11 years ago)
PAC ID
6901160795
Group Practice PAC ID
2860390283
Professional Enrollment ID
I20240711003029
Address ID
HI967276902HO45XXXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:11State licenses:3Digital endpointsOther names

5,791 EMERGENCY MEDICINE in CA

Provider Addresses for GUY RICHARD JR. BENNALLACK (DO)

  • 1400 E CHURCH ST BLDG 8

    SANTA MARIA, CA 934545906

    Phone: (805) 739-3374

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180502001656IFamily PracticeCATBD
I20200401000984IEmergency MedicineTXTBD
I20240711003029IFamily PracticeHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only179153$0
99285Emergency department visit with high level of medical decision making156146$0
99284Emergency department visit with moderate level of medical decision making138128$0
99291Critical care, first 30-74 minutes6663$0
99283Emergency department visit with low level of medical decision making2120$0
View full utilization report →

Insurance plans in this area (ZIP 93454)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860390283View full group profile
NameSpecialtyState
Emergency MedicinePA
Emergency MedicineCA
Emergency MedicineHI
Emergency MedicineNC
Nurse PractitionerHI
Emergency MedicineCE
Emergency MedicineHI
Emergency MedicineNC
Emergency MedicineHI
Emergency Medicine, Family PracticeMO

Reviews

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Frequently asked questions

Can I use this page to confirm GUY RICHARD JR. BENNALLACK (DO)'s NPI?
Yes. GUY RICHARD JR. BENNALLACK (DO) is listed with NPI 1245610344 in the public NPI dataset.
Does CMS list GUY RICHARD JR. BENNALLACK (DO) as active?
Yes — GUY RICHARD JR. BENNALLACK (DO) is active in the NPI listing used on this page.
What is GUY RICHARD JR. BENNALLACK (DO)'s specialty?
The listing groups GUY RICHARD JR. BENNALLACK (DO) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for GUY RICHARD JR. BENNALLACK (DO)?
GUY RICHARD JR. BENNALLACK (DO)'s geographic hint is Santa Maria, California in our summary view.
Is the information about GUY RICHARD JR. BENNALLACK (DO) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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