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DR. MIKAELA BENLULU DDS
NPI 1295275642
Dentist - General Practice in Boynton Beach, FL

Active since March 06, 2017PECOS Enrolled
2623 S SEACREST BLVD STE 112, BOYNTON BEACH, FL 33435(561) 810-8790 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Mikaela Benlulu Dds NPPES

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

DR. MIKAELA BENLULU DDS (NPI 1295275642) is an individual general practice provider in Boynton Beach, Florida, licensed in California (103748) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1295275642
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MIKAELA BENLULUCredential: DDS
Location Address2623 S SEACREST BLVD STE 112Boynton Beach, FL 33435-7531
Mailing Address639 E Ocean Ave Ste 409Boynton Beach, FL 33435-5017 · (561) 735-6553
Phone(561) 810-8790
Sole ProprietorYes
Enumeration DateMarch 6, 2017
Last NPPES UpdateMay 30, 2024
NPPES CertifiedMay 30, 2024
✔ NPI 1295275642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 103748
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2623 S SEACREST BLVD STE 112, Boynton Beach, FL 33435
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Other Names 1

Former Name (1)Mrs. Mikaela Goodman

Secondary Practice Locations 2

Location 19193 Sierra Ave Ste AFontana, CA 92335-4776 · Phone (909) 365-3565
Location 21100 N State St, Clinic Tower A3CLos Angeles, CA 90033-5000 · Phone (323) 409-5014

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Anthem Blue Cross and Blue Shield and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mikaela Benlulu Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mikaela Benlulu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Genesis Community Health, Inc.
1.3 mi
Federally Qualified Health Center (FQHC)
709 S FEDERAL HWY STE 3
Boynton Beach, FL 33435
  • Reassigned Medicare billing, Florida enrollment
  • 19 clinicians in this Medicare group
NPI 1447578125 (561) 735-6553

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33435 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.69 typical visit price
range $58.56 – $179.05
Typical copayment $22.92 (range $14.64 – $44.76)
Most-billed visit code 99203
Established Patient
$73.00 typical visit price
range $18.44 – $144.68
Typical copayment $18.25 (range $4.61 – $36.17)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GENESIS COMMUNITY HEALTH, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
2623 S SEACREST BLVD STE 112
BOYNTON BEACH, FL 33435
Palm Beach County (561) 810-8790
SAVA ESTANBOLIAH
Dentist (General Practice)
2623 S SEACREST BLVD STE 112
BOYNTON BEACH, FL 33435
Palm Beach County (561) 810-8790

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 Mikaela Benlulu's NPI number?

The NPI number for Mikaela Benlulu is 1295275642. It was assigned to this individual provider in the NPPES registry on March 6, 2017. The provider is also known as Mrs. Mikaela Goodman.

Where is Mikaela Benlulu located?

Mikaela Benlulu practices at 2623 S Seacrest Blvd Ste 112, Boynton Beach, FL 33435. The listed phone number is (561) 810-8790.

What is Mikaela Benlulu's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mikaela Benlulu enrolled in Medicare?

Yes. Mikaela Benlulu is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mikaela Benlulu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mikaela Benlulu reassigns Medicare benefits to Genesis Community Health, Inc. (Boynton Beach, FL). The 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 Mikaela Benlulu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mikaela Benlulu accept?

Health plans from Ambetter Health, Ambetter of Alabama, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 9 other insurers list Mikaela Benlulu as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mikaela Benlulu was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.