NPIMap

Individual provider Active NPI

Benjamin Ujlaki

  • Internal Medicine Physician
  • Vienna, WV
National Provider Identifier
1043866726
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31615 Issued in WV
Practice address
800 Grand Central Mall Ste 4
Vienna, WV 26105-4199
Phone
(304) 485-3300
Fax
(304) 485-3317
NPI assigned
Aug 17, 2019
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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 NU
Internal Medicine Physician 207R00000X 31615 WV Primary

Addresses

Primary practice location

800 Grand Central Mall Ste 4
Vienna, WV 26105-4199

Mailing address

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-8278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20230216001862 WV Practitioner - Family Practice 3870965056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

800 Grand Central Mall
Suite 4
Vienna, WV 26105-4100
Phone (304) 485-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Camden-Clark Physician Corporation CurrentSince Apr 1, 2023 Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients

Locations

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

800 Grand Central Mall
Ste 4
Vienna, WV 26105
Phone (304) 485-3300

Interoperability endpoints

  • Direct secure messaging: bujlaki360843@direct.wvuhsdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1566000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1043866726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200103017",
            "telephone_number": "202-877-8278",
            "fax_number": "202-877-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CENTRAL MALL STE 4",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261054199",
            "telephone_number": "304-485-3300",
            "fax_number": "304-485-3317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UJLAKI",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-17",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "31615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

Verify at the official NPI Registry.