NPIMap

Individual provider Active NPI

Benjamin K Marble, DPM

  • Foot & Ankle Surgery Podiatrist
  • Pueblo, CO
National Provider Identifier
1023172426
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
665 Issued in CO
Practice address
1619 N Greenwood St
# 300
Pueblo, CO 81003-2657
Phone
(719) 543-2476
Fax
(719) 543-2479
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 665 CO Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 5943612-0501 UT

Addresses

Primary practice location

1619 N Greenwood St
# 300
Pueblo, CO 81003-2657

Mailing address

1619 N Greenwood St
#300
Pueblo, CO 81003-2657
Phone (719) 543-2476

Other identifiers 2

IdentifierTypeStateIssuer
19253044MedicaidCO
P00412290OtherCORAILROAD MEDICAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20070628000341 CO Practitioner - Podiatry 2163521303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1619 N Greenwood St
Suite 300
Pueblo, CO 81003-2657
Phone (719) 543-2476

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.41 of 100Reported as group
Quality
63.76
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue158
Removal of nail tissue311
Removal or shaving of skin growth149
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
665COMDPsychoanalysis Psychologist
5943612-0501UTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Ankle and Foot Care, PLLC Foot & Ankle Surgery CurrentSince Aug 1, 2007 Accepting new patients
Pueblo Ankle and Foot Care, PLLC Podiatrist CurrentSince Aug 1, 2007 Accepting new patients

Locations

1619 N Greenwood St
Ste 300
Pueblo, CO 81003
Phone (719) 543-2476

323 S Purcell Blvd
Pueblo West, CO 81007
Phone (719) 543-2476

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO
  • CO HMO D-SNP

Interoperability endpoints

  • Direct secure messaging: drmarble@pafc.emadirect.md

Organizations & group practices 2

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 7

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1023172426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "#300",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032657",
            "telephone_number": "719-543-2476",
            "fax_number": "719-543-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "# 300",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032657",
            "telephone_number": "719-543-2476",
            "fax_number": "719-543-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBLE",
        "first_name": "BENJAMIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "665",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "5943612-0501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19253044",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICAR",
            "identifier": "P00412290",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.