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DEREK T BENNETSEN DO NPI 1720011232


NPI Information

NPI: 1720011232
Provider Name: DEREK T BENNETSEN, DO
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
12221 MERIT DR
SUITE 1610
DALLAS, TX
ZIP 75251
Phone: (214) 217-1911
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Derek T Bennetsen, DO is an emergency medicine in Dallas, TX. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Derek T Bennetsen, DO NPI is 1720011232. 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:

12221 MERIT DR
SUITE 1610
DALLAS, TX
ZIP 75251-202
Phone: (214) 217-1911

The NPI 1720011232 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 11/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineM2257TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18G6685MEDICARE PINTEXAS
2P00388057OTHERTEXASRAILROAD
38W1788OTHERTEXASBCBS
4I59913MEDICARE UPINTEXAS
590058763MEDICAIDNEW MEXICO
6181816301MEDICAIDTEXAS
78L1132MEDICARE PINTEXAS
88W0731OTHERTEXASBCBS
9181816304MEDICAIDTEXAS
108L0595MEDICARE PINTEXAS
118AL417OTHERTEXASBCBS
12181816302MEDICAIDTEXAS

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.