JOHN R BENNETT (MD) – Emergency Medicine Physician, NPI 1558385666
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JOHN R BENNETT (MD)
14701 179th Ave SE
Monroe, WA 982721108
Phone: (206) 782-2700
Type: Location
203 S WESTERN AVE
C/O: CREDENTIALING
TONASKET, WA 988558803
Phone: (509) 486-3144
Fax: (509) 486-3176
Type: Mailing
EvergreenHealth Monroe, 14701, 179th Avenue Southeast, Monroe, Snohomish County, Washington, 98272, United States
MONROE, WA 982721108
Phone: (206) 782-2700
Type: Location
210, Northeast 91st Street, Licton Springs, Maple Leaf, Seattle, King County, Washington, 98115, United States
SEATTLE, WA 981152713
Phone: (206) 729-3833
Fax: (206) 729-2509
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: 2016-04-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20040505001492 | I | Emergency Medicine | WA | TBD |
| I20160401001121 | I | Emergency Medicine | TX | 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 98272)
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