MADISON RILEY BENNERT – Physician Assistant, NPI 1023847704

MADISON RILEY BENNERT is a healthcare provider. based in Forked river, New Jersey. specializing in PHYSICIAN ASSISTANT. They hold a License No. 25MP00877800 (NJ). The NPI Number for MADISON RILEY BENNERT is 1023847704

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
MADISON RILEY BENNERT
NPI
1023847704
Phone
(732) 977-6240
Address
730 LACEY RD STE 8
Enumeration Date
30 July 2024
Last Update Date
21 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
0840727798
Group Practice PAC ID
9133032519
Professional Enrollment ID
I20241217002227
Address ID
NJ077530000NE3600X66XX358
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

3,606 PHYSICIAN ASSISTANT in NJ

Provider Addresses for MADISON RILEY BENNERT

  • 730 LACEY RD STE 8

    FORKED RIVER, NJ 087311300

    Phone: (732) 977-6240

    Type: Mailing

  • 1140 NJ Route 72

    Stafford Township, NJ 08050

    Phone: (609) 978-9841

    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: 2024-12-17

PECOS data refreshed: 2026-06-15

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
I20241217002227IPhysician AssistantNJTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08731)

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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: 9133032519View full group profile
NameSpecialtyState
-NY
-NJ
Geriatric Medicine, Internal MedicineNJ
G A S T R O E N T E R O L O G YNJ
Physician AssistantNY
General SurgeryNJ
-NJ
N E U R O L O G YNJ
Nurse PractitionerNJ
Physical Medicine And RehabilitationNJ

Reviews

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Frequently asked questions

Is there an official ID for MADISON RILEY BENNERT in U.S. healthcare records?
The official identifier for MADISON RILEY BENNERT is NPI 1023847704.
Is MADISON RILEY BENNERT shown as active in public data?
Registry records indicate MADISON RILEY BENNERT maintains an active NPI.
What clinical focus is listed for MADISON RILEY BENNERT?
At a glance, MADISON RILEY BENNERT is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with MADISON RILEY BENNERT?
Directory geography for MADISON RILEY BENNERT centers on Forked River, New Jersey.
When was this NPI issued?
Enumeration for MADISON RILEY BENNERT is noted as July 30, 2024 where the registry provides it.

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