Individual provider Active NPI

Benjamin Jon Nelson, M.D.

  • Urology Physician
  • Newark, NY
National Provider Identifier
1023375011
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
280945 Issued in NY
Practice address
1202 Driving Park Ave
Newark, NY 14513
Phone
(315) 359-2690
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Urology Physician 208800000X 280945 NY Primary

Addresses

Primary practice location

1202 Driving Park Ave
Newark, NY 14513

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504
Phone (585) 922-1304

Other practice location 1

601 Elmwood Ave
Box SURG
Rochester, NY 14642-0001
Phone (585) 275-2723

Other practice location 2

6532 Anthony Dr
Victor, NY 14564-1403
Phone (585) 398-8253

Other practice location 3

200 North St
Geneva, NY 14456-1561
Phone (315) 787-5272

Other practice location 4

220 Linden Oaks Ste 100
Rochester, NY 14625-2839
Phone (585) 248-2019

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Benjamin.Nelson@rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20180802002847 NY Practitioner - Urology 9436407756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3122

2420 Ridgeway Ave
Rochester, NY 14626-4114
Phone (585) 227-4000

2615 Culver Rd
Suite 100
Rochester, NY 14609-1716
Phone (585) 336-5320

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • Newark-Wayne Community Hospital Hospital, Newark, NY, CCN 330030
  • Clifton Springs Hospital and Clinic Hospital, Clifton Springs, NY, CCN 330265
  • Geneva General Hospital Hospital, Geneva, NY, CCN 330058
  • Strong Memorial Hospital Hospital, Rochester, NY, CCN 330285

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection32
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280945NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Aug 13, 2018 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Aug 13, 2018 Accepting new patients
Rochester General Hospital Current Accepting new patients
Rochester General Hospital CurrentSince Aug 13, 2018 Accepting new patients

Locations

200 North St
Geneva, NY 14456
Phone (315) 787-5100

1202 Driving Park Ave
Newark, NY 14513
Phone (315) 331-2030

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

220 Linden Oaks
Ste 100
Rochester, NY 14625
Phone (585) 248-2019

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

2420 Ridgeway Ave
Rochester, NY 14626
Phone (585) 227-4000

2615 Culver Rd
Ste 100
Rochester, NY 14609
Phone (585) 336-5320

6532 Anthony Dr
Victor, NY 14564
Phone (315) 359-2690

Interoperability endpoints

  • Direct secure messaging: bnelson@cfu.medentdirect.com
  • Direct secure messaging: benjamin.nelson@rochesterregional.org

Organizations & group practices 4

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1023375011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 DRIVING PARK AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "14513",
            "telephone_number": "315-359-2690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave",
            "address_2": "Box SURG",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-2723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6532 Anthony Dr",
            "address_purpose": "LOCATION",
            "city": "Victor",
            "state": "NY",
            "postal_code": "145641403",
            "country_code": "US",
            "telephone_number": "585-398-8253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 North St",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144561561",
            "country_code": "US",
            "telephone_number": "315-787-5272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Linden Oaks Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146252839",
            "country_code": "US",
            "telephone_number": "585-248-2019",
            "fax_number": "585-586-1755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BENJAMIN",
        "middle_name": "JON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "280945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Benjamin.Nelson@rochesterregional.org",
            "affiliation": "N",
            "address_1": "1202 Driving Park Ave",
            "city": "Newark",
            "state": "NY",
            "country_code": "US",
            "postal_code": "14513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

Verify at the official NPI Registry.