NPIMap

Individual provider Active NPI

Benjamin Daniel Kevan, ATC, PAC

  • Physician Assistant
  • Corvallis, OR
National Provider Identifier
1013960368
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01366 Issued in OR
Practice address
3620 NW Samaritan Dr Ste 202
Corvallis, OR 97330-3785
Phone
(541) 768-4810
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 791039 WI
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA01366 OR Primary

Addresses

Primary practice location

3620 NW Samaritan Dr Ste 202
Corvallis, OR 97330-3785

Mailing address

PO Box 1189
Corvallis, OR 97339-1189

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bkevan7072@samhealth.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080825000466 OR Practitioner - Physician Assistant 4284709361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital CorvallisGroup PAC ID 1557270725, 372 clinicians

Practice addresses (Care Compare)

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

3620 NW Samaritan Dr
Corvallis, OR 97330-3785

3620 NW Samaritan Dr
Corvallis, OR 97330-4714

Hospital & facility affiliations

  • Good Samaritan Regional Medical Center Hospital, Corvallis, OR, CCN 380014
  • Samaritan Lebanon Community Hospital Hospital, Lebanon, OR, CCN 381323
  • Samaritan Albany General Hospital Hospital, Albany, OR, CCN 380022
  • Samaritan Pacific Community Hospital Hospital, Newport, OR, CCN 381314

Merit-based Incentive Payment System (MIPS)

Final score
91.14 of 100Reported as group
Quality
85.78
Promoting interoperability
100
Improvement activities
40
Cost
78.31

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
86.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
791039WIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Corvallis CurrentSince Sep 1, 2012 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Sep 1, 2012 Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Physician Assistant PastSince Sep 1, 2004 Accepting new patients

Locations

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

3620 NW Samaritan Dr
Ste 202
Corvallis, OR 97330
Phone (541) 768-4810

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

3600 NW Samaritan Dr
Corvallis, OR 97330
Phone (541) 768-4906

Interoperability endpoints

  • Direct secure messaging: bkevan7072@samhealth.direct-ci.com

Organizations & group practices 5

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 66

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

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1013960368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 NW SAMARITAN DR STE 202",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303785",
            "telephone_number": "541-768-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEVAN",
        "first_name": "BENJAMIN",
        "middle_name": "DANIEL",
        "credential": "ATC, PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "791039",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bkevan7072@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3620 NW Samaritan Dr Ste 202",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.