DR. JONATHAN JAMES BENNETT (MD) – Family Medicine Physician, NPI 1003479171
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
971 FAMILY PRACTICE in ID
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Provider Addresses for DR. JONATHAN JAMES BENNETT (MD)
Family Medicine/Dental Sciences, 465, Memorial Drive, Pocatello, Bannock County, Idaho, 83201, United States
POCATELLO, ID 832014008
Phone: (208) 234-4700
Fax: (208) 282-4696
Type: Mailing
424 MN-5
WACONIA, MN 55387
Phone: (952) 442-4461
Type: Mailing
313 TERRITORIAL ST E
WATERTOWN, MN 553889284
Phone: (952) 955-1921
Type: Location
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: 2022-07-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220726002672 | I | Family Practice | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 106 | 91 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 83 | 66 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 76 | 55 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 51 | 42 | $0 |
| 80053 | Blood test, comprehensive group of blood chemicals | 46 | 39 | $0 |
Insurance plans in this area (ZIP 83201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| Family Practice | MN | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| General Surgery | MN | |
| - | MN | |
| Nurse Practitioner | MN | |
| Internal Medicine | MN | |
| Internal Medicine | MN | |
| Family Practice | MN | |
| Family Practice | MN |
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