Dr Benjamin Souferi, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Cleveland, Ohio. His current practice location is
9500 Euclid Ave # Jj24, Cleveland, Ohio. You can reach out to his office (for appointments etc.) via phone at
(216) 444-2200.
Dr Benjamin Souferi is licensed to practice in Ohio (license number 34.017971) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1033882261.
Physician's Profile
| Full Name | Dr Benjamin Souferi |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 9500 Euclid Ave # Jj24, Cleveland, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1033882261
- Provider Enumeration Date: 07/25/2021
- Last Update Date: 06/16/2025
Medicare PECOS Information:
- PECOS PAC ID: 0042730558
- Enrollment ID: I20250226003294
Medical Identifiers
Medical identifiers for Dr Benjamin Souferi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033882261 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 34.017971 (Ohio) | Secondary |
| 207P00000X | Emergency Medicine | 332470 (New York) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 34.017971 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Benjamin Souferi allows following entities to bill medicare on his behalf.
| Entity Name | Divinity Medical Services Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497159560
PECOS PAC ID: 5193030245
Enrollment ID: O20150818005362 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Benjamin Souferi is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Benjamin Souferi, DO
121 Andover Rd,
Roslyn Heights, NY 11577-1803
Ph: (516) 343-6426 | Dr Benjamin Souferi, DO
9500 Euclid Ave # Jj24,
Cleveland, OH 44195-3923
Ph: (216) 444-2200 |
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