SEAN P BENNER (DO) – Emergency Medicine Physician, NPI 1124642095

SEAN P BENNER (DO) is a healthcare provider. based in Pontiac, Michigan. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 5101027325 (MI). The NPI Number for SEAN P BENNER (DO) is 1124642095

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
SEAN P BENNER (DO)
NPI
1124642095
Phone
(248) 338-5392
Address
50 N PERRY ST
Enumeration Date
5 June 2020
Last Update Date
1 October 2024

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
2485362127
Graduation Year
2020 (6 years ago)
PAC ID
2668897166
Group Practice PAC ID
6800234592
Professional Enrollment ID
I20230518002407
Address ID
MI492011753JA205XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

3,158 EMERGENCY MEDICINE in MI

Provider Addresses for SEAN P BENNER (DO)

  • 50 N PERRY ST

    PONTIAC, MI 483422217

    Phone: (248) 338-5392

    Type: Mailing

  • 37000 Grand River Ave Ste 310

    Farmington Hills, MI 483352868

    Phone: (248) 536-2127

    Fax: (248) 893-6952

    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: 2023-05-18

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230518002407IEmergency MedicineMITBD

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
99285Emergency department visit with high level of medical decision making2929$0
99284Emergency department visit with moderate level of medical decision making2322$0
View full utilization report →

Insurance plans in this area (ZIP 48342)

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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: 6800234592View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineMI
Physician AssistantMI

Reviews

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Frequently asked questions

What unique ID ties claims to SEAN P BENNER (DO)?
NPI 1124642095 is assigned to SEAN P BENNER (DO) under the national enumeration system.
Is SEAN P BENNER (DO) active in the national directory?
SEAN P BENNER (DO)'s public NPI profile is in an active state.
What field does SEAN P BENNER (DO) work in?
You can think of SEAN P BENNER (DO) as practicing within Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for SEAN P BENNER (DO)?
The page summarizes Pontiac, Michigan for SEAN P BENNER (DO); expand the address list for detail.
Is SEAN P BENNER (DO) a real provider?
This page reflects official NPPES data for NPI 1124642095. Always confirm identity and privileges with the practice and licensing boards.

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