Individual provider Active NPI

Benjamin E Phillips, M.D.

  • Ophthalmology Physician
  • Manitowoc, WI
National Provider Identifier
1003808676
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
44214-020 Issued in WI
Practice address
1111 Bayshore Dr
Manitowoc, WI 54220-5548
Phone
(920) 684-4429
Fax
(920) 684-6892
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 44214-020 WI Primary

Addresses

Primary practice location

1111 Bayshore Dr
Manitowoc, WI 54220-5548

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320
Phone (920) 490-9046

Other identifiers 2

IdentifierTypeStateIssuer
34181000MedicaidWI
0376640002OtherWIADMINASTAR FEDERAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bphillips81561@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040823001137 WI Practitioner - Ophthalmology 8820062136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Mayo Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Clinic LLPGroup PAC ID 4385554328, 197 clinicians

Practice addresses (Care Compare)

4801 Expo Dr
Manitowoc, WI 54220-9341
Phone (920) 684-4429

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.21 of 100Reported as group
Quality
78.54
Promoting interoperability
100
Improvement activities
40
Cost
75.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44214-020WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP Ophthalmology CurrentSince Jul 29, 2015 Accepting new patients
Two Rivers Eye Clinic Ophthalmology Current Accepting new patients
Baycare Clinic LLP CurrentSince Jul 29, 2015 Accepting new patients

Locations

164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

4801 Expo Dr
Manitowoc, WI 54220
Phone (920) 684-4429

1111 Bayshore Dr
Manitowoc, WI 54220
Phone (920) 682-6376

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • IL PPO Downstate
  • IL HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: bphillips148990@direct.froedtert.com
  • Direct secure messaging: bphillips81561@direct.myadvocateaurora.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1003808676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAYSHORE DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205548",
            "telephone_number": "920-684-4429",
            "fax_number": "920-684-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BENJAMIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "44214-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34181000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR FEDERAL",
            "identifier": "0376640002",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bphillips81561@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "4801 Expo Dr",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542209341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.