BENJAMIN HABERLY NPI 1679176200

NPI Information

  • NPI: 1679176200
  • Provider Name: BENJAMIN HABERLY
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 53880 CARMICHAEL DR
    SOUTH BEND, IN
    ZIP 46635
  • Phone: (574) 247-9441

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NPI Details

Benjamin Haberly is a surgical physician assistant in South Bend, IN with 6 years of experience. Benjamin Haberly NPI is 1679176200. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

53880 CARMICHAEL DR
SOUTH BEND, IN
ZIP 46635-567
Phone: (574) 247-9441

The NPI 1679176200 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • X-ray of knee, 3 views (HCPCS:73562)
  • X-ray of hip, 2-3 views (HCPCS:73502)
  • Replacement of thigh bone and hip joint with prosthesis (HCPCS:27130)
  • Hyaluronan or derivative, monovisc, for intra-articular injection, per dose (HCPCS:J7327)
  • Replacement of knee joint, both sides of knee (HCPCS:27447)
  • X-ray of knee, 4 or more views (HCPCS:73564)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Insertion of drug delivery implant into tissue (HCPCS:11981)
  • Revision of thigh and lower leg bone components of total knee joint prosthesis (HCPCS:27487)

The enumeration date for this NPI number is 11/17/2020 and was last updated on 1/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical10003022AINDIANAYes
2363A00000XPhysician Assistant10003022AINDIANANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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