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BROADWAY MEDICAL CLINIC
NPI 1275936270
Internal Medicine in El Cajon, CA

Active since October 03, 2014CLIA 05D2197090 · Waiver
1351 BROADWAY, EL CAJON, CA 92021(619) 383-6703(866) 473-3324 Get Directions Write a Review

NPPES record last updated: February 7, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 7, 2022, Jun 20, 2016 (2 updates tracked since 2016).

About Broadway Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROADWAY MEDICAL CLINIC (NPI 1275936270) is a healthcare organization registered as an internal medicine in El Cajon, California and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through October 20, 2028 and lists Jimi Ola Benson, President, as its authorized official.

NPPES Registry Identity

NPI1275936270
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJIMI O. BENSON MD., INC
Location Address1351 BROADWAYEl Cajon, CA 92021-5811
Mailing Address1351 BroadwayEl Cajon, CA 92021-5811 · (619) 383-6703 · Fax (866) 473-3324
Phone(619) 383-6703
Fax(866) 473-3324
Organization SubpartNo
Authorized OfficialJimi Ola BensonPresident · (301) 466-1078
Enumeration DateOctober 3, 2014
Last NPPES UpdateFebruary 7, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2022
✔ NPI 1275936270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A116611
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1351 BROADWAY, El Cajon, CA 92021
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Other Names 1

Doing Business AsBroadway Medical Clinic

Other Identifiers 2

Medicaid1275936270CA
Medicaid1477751667CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Broadway Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Broadway Medical Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jimi Benson, M.D.
Internal Medicine
NPI 1477751667
1351 BROADWAY
El Cajon, CA 92021
(619) 383-6703
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2197090

Broadway Medical Clinic · El Cajon, CA
Active · expires Oct 20, 2028
CLIA Number05D2197090
Laboratory TypePhysician Office
Certificate Effective DateOctober 21, 2026
Certificate Expiration DateOctober 20, 2028
Laboratory DirectorJimi Benson
Laboratory Phone(301) 466-1078
Laboratory LocationBroadway Medical Clinic1351 Broadway, El Cajon, CA 92021
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jimi O. Benson MD., Inc's NPI number?

The NPI number for Jimi O. Benson MD., Inc is 1275936270. It was assigned to this organization in the NPPES registry on October 3, 2014. The provider is doing business as Broadway Medical Clinic.

Where is Jimi O. Benson MD., Inc located?

Jimi O. Benson MD., Inc is located at 1351 Broadway, El Cajon, CA 92021. The listed phone number is (619) 383-6703.

What is Jimi O. Benson MD., Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jimi O. Benson MD., Inc enrolled in Medicare?

Yes. Jimi O. Benson MD., Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Jimi O. Benson MD., Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Jimi O. Benson MD., Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Jimi O. Benson MD., Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2197090) is associated with this NPI, valid through October 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jimi O. Benson MD., Inc was last updated on February 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.