BENJAMIN MATTHEW BRYAN (LCSW) – Clinical Social Worker, NPI 1306912324

BENJAMIN MATTHEW BRYAN (LCSW) is a healthcare provider. based in Medford, Oregon. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. L5304 (OR). The NPI Number for BENJAMIN MATTHEW BRYAN (LCSW) is 1306912324

Main info

Male
17 Years Of Experience
Accepts Medicare Assignment
Name
BENJAMIN MATTHEW BRYAN (LCSW)
NPI
1306912324
Phone
(541) 476-2373
Address
200 BEATTY ST
Enumeration Date
28 November 2006
Last Update Date
7 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5414762373
Graduation Year
2009 (17 years ago)
PAC ID
9133555303
Group Practice PAC ID
0941202006
Professional Enrollment ID
I20200206001332
Address ID
OR975011630ME1911XAVEX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,405 CLINICAL SOCIAL WORKER in OR

Provider Addresses for BENJAMIN MATTHEW BRYAN (LCSW)

  • 200 BEATTY ST

    MEDFORD, OR 975015811

    Phone: (541) 476-2373

    Type: Location

  • 1911 HAZEL AVE

    MEDFORD, OR 975011630

    Phone: (541) 476-2373

    Fax: (541) 774-7979

    Type: Location

  • 1215, Southwest G Street, Grants Pass, Josephine County, Oregon, 97526, United States

    GRANTS PASS, OR 975262544

    Phone: (541) 476-2373

    Fax: (541) 774-7979

    Type: Mailing

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: 2020-02-06

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
I20200206001332IClinical Social WorkerORTBD

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 97501)

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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: 0941202006View full group profile
NameSpecialtyState
P S Y C H I A T R YOR
Mental Health CounselorOR
Undefined Non Physician Type (Specify)OR
Clinical Social WorkerOR
Clinical Social WorkerOR
Clinical Social WorkerOR
Mental Health CounselorOR
-OR
Mental Health CounselorOR
-VA

Reviews

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Frequently asked questions

Can I verify BENJAMIN MATTHEW BRYAN (LCSW) with an NPI only?
You can start verification with NPI 1306912324 for BENJAMIN MATTHEW BRYAN (LCSW), then check state licensing separately.
Does the file indicate BENJAMIN MATTHEW BRYAN (LCSW) is practicing under active NPI?
Directory data currently reports BENJAMIN MATTHEW BRYAN (LCSW) as active.
What taxonomy line describes BENJAMIN MATTHEW BRYAN (LCSW)?
For research purposes, treat BENJAMIN MATTHEW BRYAN (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What area does BENJAMIN MATTHEW BRYAN (LCSW) serve?
BENJAMIN MATTHEW BRYAN (LCSW)'s listing highlights Medford, Oregon; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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