Individual provider Active NPI

Benjamin J. Werner, D.P.M.

  • Podiatrist
  • Dothan, AL
National Provider Identifier
1063484004
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
204 Issued in AL
Practice address
1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone
(334) 793-2663
Fax
(334) 836-2248
NPI assigned
Feb 3, 2006
Last updated
Nov 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 204 AL Primary

Addresses

Primary practice location

1500 Ross Clark Cir
Dothan, AL 36301-4754

Mailing address

PO Box 729
Dothan, AL 36302-0729
Phone (334) 793-2663

Other identifiers 6

IdentifierTypeStateIssuer
009995495MedicaidAL
121545MedicaidAL
511-09066OtherALBCBS OF AL - HEALTHWEST
810610880AMedicaidGA
515-27019OtherALBCBS OF AL 1500 RCC
810610880EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000942 AL Practitioner - Podiatry 6002855459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S.B.J.S. PCGroup PAC ID 8527043421, 39 clinicians

Practice addresses (Care Compare)

1500 Ross Clark Cir
Dothan, AL 36301-4754
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303-2053
Phone (334) 793-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue41
Removal of nail tissue819
Removal or shaving of skin growth250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SBJS PC Podiatrist CurrentSince Apr 1, 2005 Accepting new patients
S.B.J.S. PC CurrentSince Apr 1, 2005 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
S.B.J.S. PC Past Accepting new patients

Locations

1500 Ross Clark Cir
Dothan, AL 36301
Phone (334) 793-2663

345 Healthwest Dr
Dothan, AL 36303
Phone (334) 793-2663

Interoperability endpoints

  • Direct secure messaging: benjamin.werner.1@15455.direct.athenahealth.com

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

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1063484004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363020729",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363014754",
            "telephone_number": "334-793-2663",
            "fax_number": "334-836-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "BENJAMIN",
        "middle_name": "J.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009995495",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121545",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL - HEALTHWEST",
            "identifier": "511-09066",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810610880A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL  1500 RCC",
            "identifier": "515-27019",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810610880E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.