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Deactivated NPI 1104114941 Deactivated / Inactive NPI Male Practitioner

Dr. Samson Adam Benjamin , MD

Specialist • La Porte, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Samson Benjamin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 14, 2011
NPI Deactivation Date March 13, 2024
Total Practice Duration ~13 Years of Practice (2011 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Samson Benjamin, MD was a registered Specialist practicing in La Porte, IN. Throughout an active medical career spanning 13 years, Dr. Benjamin provided care at the practice location at 901 LINCOLNWAY until profile deactivation on 2024-03-13.

Practice Location & Contact Primary Location

Practice Address

901 Lincolnway
Suite 108

La Porte, IN 463503430

Telephone 2193247971
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in La Porte, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 34.9 Yrs
Regional Practice Density
10 Specialists

Practicing in La Porte, IN (456 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License IN 01022675B

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. David Gorecki , MD

Internal Medicine - Cardiovascular Disease

NPI 1316923444

Doctor of Medicine (M.D.)

Dr. Alexander Igolnikov , MD

Internal Medicine - Gastroenterology

NPI 1437249182

Doctor of Medicine (M.D.)

NPI 1457545733

Doctor of Medicine (M.D.)

Judith Hundt , NP

Obstetrics & Gynecology

NPI 1467501049

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 13, 2024

Record deactivated on March 13, 2024

NPI Profile Active July 14, 2011

NPI status registered as active in NPPES database

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Updated Practice Location July 14, 2011

Registered at 901 LINCOLNWAY, SUITE 108, LA PORTE, IN 463503430 (Tel: 2193247971)

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Updated Business Mailing Address July 14, 2011

Registered at 901 LINCOLNWAY, SUITE 108, LA PORTE, IN 463503430 (Tel: 2193247971)

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Provider Name / Credentials Updated July 14, 2011

Recorded as SAMSON BENJAMIN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 14, 2011

Specialist (License #01022675B in IN)

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Initial NPI Registration & Enumeration July 14, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104114941
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 14, 2011
Last Update: July 14, 2011
Deactivation Date: March 13, 2024

Mailing Address

901 Lincolnway, Suite 108

La Porte, IN 463503430

Phone: 2193247971

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.