Benjamin R Proto, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103300835 Issued in VA

Practice address

860 Omni Blvd
Suite 113
Newport News, VA 23606

Phone

(757) 327-0657

Fax

(757) 327-0658

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Podiatry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Home Care Services-Williamsburg Home health agency, Williamsburg, VA, CCN 497748
• Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066
• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093
• Mary Immaculate Hospital Hospital, Newport News, VA, CCN 490041

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment Care Compare group NPD
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD
• Tidewater Podiatry Group

  • Foot & Ankle Surgery Podiatrist
  • Virginia Beach, VA
  • NPI 1043449846
  NPD (past)
• Tidewater Podiatry Group LTD

  • Foot & Ankle Surgery Podiatrist
  • Norfolk, VA
  • NPI 1356542922
  NPD (past)

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

• Mary Immaculate Hospital LLC

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1427064310
  Care Compare affiliation
• Sentara Enterprises

  • Home Health Agency
  • Williamsburg, VA
  • NPI 1750829164
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Careplex Hospital

  • General Acute Care Hospital
  • Hampton, VA
  • NPI 1336109107
  Care Compare affiliation
• Sentara Hospitals

  dba Sentara Williamsburg Regional Medical Center

  • General Acute Care Hospital
  • Williamsburg, VA
  • NPI 1619938149
  Care Compare affiliation

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1073506291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 303",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-232-8777",
            "fax_number": "757-232-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 OMNI BLVD",
            "address_2": "SUITE 113",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "23606",
            "telephone_number": "757-327-0657",
            "fax_number": "757-327-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROTO",
        "first_name": "BENJAMIN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "VA",
            "license": "0103300835",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103300835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073506291",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "236542",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9304797",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA PROVIDER NUMBER",
            "identifier": "58381",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA/MAMSI PROVIDER NUM",
            "identifier": "394596",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• PRP Management Services, LLC (PRP Management Services)
• John Pryce, DPT
• Psychiatric Services of Virginia

• Podiatrist in Newport News, VA
• Providers in Newport News, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.