CMS-1500 Box 24J / 33a • NPI
1639827421
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
851 E 5TH ST STE 108, WASHINGTON, MO, 63090-3128
✓ 9-Digit EDI 837 ZIP+4 (63090-3128)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1639827421 (TARA BENES, PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1639827421)
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 11 |
99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 12 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 12 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1639827421 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | TARA BENES, PA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 851 E 5TH ST STE 108, WASHINGTON, MO, 63090-3128 |
| Practice Telephone / Fax | Tel: (636) 861-7870 |
| Administrative Mailing Address | 28 DELLA DR, FENTON, MO, 63026-4924 |
| Enumeration & Last Sync | Enumerated: 2022-03-11 | CMS Record Updated: 2023-07-14 |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (TARA BENES, PA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: MO | License: 2022036859 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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