Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Lassow

Individual provider Physician Assistant · NPI 1659969129

Benjamin Lassow is a Physician Assistant in Atlanta, Georgia. Qualified in 2021, 5 years ago. Practices with Trinity Health of New England Provider Network Organization Inc, a 635-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
5
Licensed in
CT
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

1364 Clifton Rd NE
Atlanta, GA 30322-1650
Phone: (404) 712-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 6023 (CT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1659969129
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 9, 2021
Last updated in NPPESSeptember 19, 2025
Certification dateSeptember 19, 2025
Mailing address1364 Clifton Rd Ne, Atlanta, GA 30322-1650

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Trinity Health Of New England Provider Network Organization Inc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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