NPIMap

Individual provider Active NPI

Benjamin Wade Wilkerson, M.D.

  • Diagnostic Radiology Physician
  • Hammond, LA
National Provider Identifier
1184833188
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
204533 Issued in LA
Practice address
15837 Paul Vega MD Dr
Hammond, LA 70403-1495
Phone
(985) 543-6079
Fax
(985) 350-9950
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 204533 LA Primary
Diagnostic Radiology Physician 2085R0202X 20280 MS

Addresses

Primary practice location

15837 Paul Vega MD Dr
Hammond, LA 70403-1495

Mailing address

PO Box 2277
Hammond, LA 70404-2277
Phone (985) 543-6079

Other identifiers 2

IdentifierTypeStateIssuer
03070723MedicaidMS
2153498MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130904000193 TN Practitioner - Diagnostic Radiology 0446443691 Reassigns benefits to 1 organization
I20131204000196 MS Practitioner - Diagnostic Radiology 0446443691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memphis Radiological PCGroup PAC ID 1557333226, 50 clinicians

Practice addresses (Care Compare)

1265 Union Ave
Memphis, TN 38104-3415
Phone (901) 516-7600

7400 Airways Blvd
Southaven, MS 38671-5863
Phone (662) 536-1000

Hospital & facility affiliations

  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167
  • Hardin Medical Center Hospital, Savannah, TN, CCN 440109
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Merit-based Incentive Payment System (MIPS)

Final score
88.97 of 100Reported as group
Quality
92.01
Improvement activities
40
Cost
77.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204533LAMDDiagnostic Radiology Physician
20280MSMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Imaging Assoc LLC Diagnostic Radiology Past Accepting new patients
Memphis Radiological, PC Past Accepting new patients
University Radiology Associates Diagnostic Radiology PastSince Feb 1, 1997 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bwilkerson23678@mlh.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1184833188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2277",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042277",
            "telephone_number": "985-543-6079",
            "fax_number": "985-350-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15837 PAUL VEGA MD DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031495",
            "telephone_number": "985-543-6079",
            "fax_number": "985-350-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "BENJAMIN",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "204533",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "20280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03070723",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2153498",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.