MARY BENSON – Family Nurse Practitioner, NPI 1043602147
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,268 NURSE PRACTITIONER in WA
Provider Addresses for MARY BENSON
300 NISSAN DR
CANTON, MS 390468562
Phone: (601) 855-8426
Type: Mailing
1251 LEWIS RIVER RD STE D
WOODLAND, WA 986749203
Phone: (360) 225-4310
Fax: (360) 225-4309
Type: Location
PO BOX 278450
SACRAMENTO, CA 958278450
Phone: (707) 262-5088
Type: Mailing
987 PARALLEL DR STE C
LAKEPORT, CA 954535708
Phone: (707) 262-5088
Type: Location
300 Nissan Dr
Canton, MS 390468562
Phone: (601) 855-8426
Type: Location
85 Lafayette St
New Britain, CT 060511803
Phone: (860) 347-6971
Fax: (860) 638-6831
Type: Location
1251 Lewis River Rd Ste D
Woodland, WA 986749203
Phone: (360) 225-4310
Fax: (360) 225-4309
Type: Location
5196 Hill Rd E Ste 300
Lakeport, CA 954536374
Phone: (916) 263-6885
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: 2024-11-26
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 |
|---|---|---|---|---|
| I20241126004033 | I | Nurse Practitioner | CA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 39046)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Family Practice | CA | |
| Family Practice | CA | |
| Physician Assistant | CO | |
| Nurse Practitioner | CA | |
| Family Practice | CA | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | CA | |
| Family Practice | PA | |
| Physician Assistant | CA |
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